Akmaz Berkay, Kilic Deniz, Duru Necati
Department of Ophthalmology, 169317Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
Department of Ophthalmology, Health Science University, 147026Kayseri City Training and Research Hospital, Kayseri, Turkey.
Eur J Ophthalmol. 2023 Jan;33(1):269-277. doi: 10.1177/11206721221116701. Epub 2022 Jul 27.
To compare and evaluate the results of phacoemulsification surgery involving and not involving an ophthalmic-viscosurgical-device (OVD).
A prospective, randomized controlled trial included 60 eyes of 60 patients scheduled to receive phacoemulsification surgery. In order of presentation, patients were randomized into two groups to undergo different surgical techniques: the OVD-free group ( = 30) and the OVD group ( = 30). Each patient's operating time, total ultrasonography (U/S) time, cumulative dissipated energy (CDE), aspiration time, and volume of balanced salt solution (BSS) aspirated were recorded. At 1 day, 1 week, and 1 and 3 months postoperation, measurements of endothelial cell density (ECD) and intraocular pressure (IOP), were taken and compared between the groups.
Total U/S time ( 567) and CDE ( 168) were similar between the groups. In the OVD group, operating time ( 011), aspiration time ( 001), and volume of BSS aspirated ( 001) were greater than in the OVD-free group. The change in ECD between the groups was not statistically significant at all visits ( 433, = 147, = .379, = .534; respectively). Although IOP increased in the OVD group at 1 day postoperation ( 001), no difference emerged between the groups at 3 months postoperation ( 121).
Phacoemulsification surgery without an OVD took less time than with the OVD and caused no significant loss in ECD. Surgeons concerned about elevated IOP following cataract surgery should apply the OVD-free method.
比较和评估使用与不使用眼科粘弹剂(OVD)的超声乳化手术结果。
一项前瞻性随机对照试验纳入了60例计划接受超声乳化手术的患者的60只眼。按照就诊顺序,患者被随机分为两组接受不同的手术技术:无OVD组(n = 30)和OVD组(n = 30)。记录每位患者的手术时间、总超声检查(U/S)时间、累积消散能量(CDE)、抽吸时间以及吸出的平衡盐溶液(BSS)量。在术后1天、1周、1个月和3个月,测量内皮细胞密度(ECD)和眼压(IOP),并在两组之间进行比较。
两组之间的总U/S时间(P =.567)和CDE(P =.168)相似。在OVD组中,手术时间(P =.011)、抽吸时间(P =.001)和吸出的BSS量(P =.001)均高于无OVD组。在所有随访中,两组之间ECD的变化无统计学意义(P分别为.433、.147、.379、.534)。虽然OVD组在术后1天眼压升高(P =.001),但术后3个月两组之间无差异(P =.121)。
不使用OVD的超声乳化手术比使用OVD的手术时间更短,且不会导致ECD显著损失。担心白内障手术后眼压升高的外科医生应采用无OVD方法。