[混合式（飞秒激光辅助）和扭转式超声乳化术中的能量负荷与角膜内皮状态]

[Energy load and state of corneal endothelium in hybrid (femtosecond laser-assisted) and torsional phacoemulsification].

作者信息

Yusef Yu N, Voronin G V, Yusef S N, Avetisov K S, Vvedenskiy A S, Ivanov M N, Alkhumidi K, Shkolyarenko N Yu, Khasyanova M V, Ryzhkova E G

机构信息

Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021.

Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021; I.M. Sechenov First Moscow State Medical University, Department of Ophthalmology, 8-2 Trubetskaya St., Moscow, Russian Federation, 119991.

出版信息

Vestn Oftalmol. 2020;136(1):42-48. doi: 10.17116/oftalma202013601142.

DOI:10.17116/oftalma202013601142

PMID:32241968

Abstract

UNLABELLED

Postoperative state of the corneal endothelium is the most important criterion for evaluating the safety of cataract phacoemulsification.

PURPOSE

To compare the intraoperative energy load and postoperative state of corneal endothelium in hybrid (femtosecond laser-assisted) and torsional phacoemulsification.

MATERIAL AND METHODS

The study analyzed surgical outcomes of 603 patients (714 eyes) divided into 3 groups: 225 patients (267 eyes) underwent modified femtosecond laser-assisted phacoemulsification (1st group), 237 patients (278 eyes) underwent standard femtosecond laser-assisted phacoemulsification (2nd group), and 141 patients (169 eyes) who underwent torsional phacoemulsification (3rd group). The follow-up period lasted up to 2 years.

RESULTS

In patients with grade II lens density (here and further - L. Buratto classification is used), effective ultrasound time was 0.56±0.11 s in the 1st group, 0.83±0.17 s in the 2nd group, and 2.78 ± 0.51 s in the 3rd group (p(1-2)<0.05; p(1-3)<0.05; p(2-3)<0.05). In patients with grade III lens density effective ultrasound time was 2.04±0.37 s in the 1st group, 2.97±0.53 s in the 2nd group, and 4.59±0.91 s in the 3rd group (p(1-2)<0.05; p(1-3)<0.05; p(2-3)<0.05). In patients with grade IV lens density, effective ultrasound time was 3.95±0.81 s in the 1st group, 5.11±1.03 s in the 2nd group, and 8.37±1.73 s in the 3rd group (p(1-2)<0.05; p(1-3)<0.05; p(2-3)<0.05). In patients with grade II lens density, loss of endothelial cells was 3.3±1.1% in the 1st group, 3.7±1.2% in the 2nd group, and 4.3±1.2% in the 3rd group (p(1-2)>0.05; p(1- 3)<0.05; p(2-3)<0.05). In patients with grade III lens density, loss of endothelial cells was 5.1±1.4% in the 1st group, 5.7±1.5% in the 2nd group, 7.2±1.7% in the 3rd group (p(1-2)>0.05; p(1-3)<0.05; p(2-3)<0.05). In patients with grade IV lens density, loss of endothelial cells was 8.9±2.1% in the 1st group, 10.1±2.3% in the 2nd group, and 13.3±2.5% in the 3rd group (p(1-2)>0.05; p(1-3)<0.05; p(2- -3)<0.05).

CONCLUSION

Both techniques of femtosecond laser-assisted phacoemulsification significantly reduce the effective ultrasound time (p<0.05) and the degree of corneal endothelial cells loss (p<0.05) compared with torsional phacoemulsification.

摘要

未标注

角膜内皮的术后状态是评估白内障超声乳化安全性的最重要标准。

目的

比较混合（飞秒激光辅助）和扭转超声乳化术中的能量负荷及角膜内皮的术后状态。

材料与方法

本研究分析了603例患者（714只眼）的手术结果，这些患者被分为3组：225例患者（267只眼）接受改良飞秒激光辅助超声乳化术（第1组），237例患者（278只眼）接受标准飞秒激光辅助超声乳化术（第2组），141例患者（169只眼）接受扭转超声乳化术（第3组）。随访期长达2年。

结果

在晶状体密度为II级的患者中（此处及以下使用L. Buratto分类法），第1组的有效超声时间为0.56±0.11秒，第2组为0.83±0.17秒，第3组为2.78±0.51秒（p(1 - 2)<0.05；p(1 - 3)<0.05；p(2 - 3)<0.05）。在晶状体密度为III级的患者中，第1组的有效超声时间为2.04±0.37秒，第2组为2.97±0.53秒，第3组为4.59±0.91秒（p(1 - 2)<0.05；p(1 - 3)<0.05；p(2 - 3)<0.05）。在晶状体密度为IV级的患者中，第1组的有效超声时间为3.95±0.81秒，第2组为5.11±1.03秒，第3组为8.37±1.73秒（p(1 - 2)<0.05；p(1 - 3)<0.05；p(2 - 3)<0.05）。在晶状体密度为II级的患者中，第1组内皮细胞损失率为3.3±1.1%，第2组为3.7±1.2%，第3组为4.3±1.2%（p(1 - 2)>0.05；p(1 - 3)<0.05；p(2 - 3)<0.05）。在晶状体密度为III级的患者中，第1组内皮细胞损失率为5.1±1.4%，第2组为5.7±1.5%，第3组为7.2±1.7%（p(1 - 2)>0.05；p(1 - 3)<0.05；p(2 - 3)<0.05）。在晶状体密度为IV级的患者中，第1组内皮细胞损失率为8.9±2.1%，第2组为10.1±2.3%，第3组为13.3±2.5%（p(1 - 2)>0.05；p(1 - 3)<0.05；p(2 - 3)<0.05）。