From the Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah (Wilkinson, Park, Ungricht, Trapnell, Nydegger, Cardenas, Mamalis, Olson, Werner); University of Utah, School of Medicine, Salt Lake City, Utah (Ungricht, Cardenas); Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah (Brintz).
J Cataract Refract Surg. 2022 Nov 1;48(11):1325-1330. doi: 10.1097/j.jcrs.0000000000001032.
To evaluate mechanical damage of simulated lenticular debris on corneal endothelial cells during phacoemulsification.
University setting, Salt Lake City, Utah.
Experimental study.
12 New Zealand rabbits underwent bilateral surgery. After incision, 10 1.0 mm beads were injected into the anterior chamber of test eyes to simulate lenticular debris. A balanced salt solution was injected into the contralateral eyes with the same injector. The Intrepid Balanced Tip of the Centurion Ozil handpiece was inserted into the anterior chamber, and 60% torsional ultrasound was applied for 20 seconds with 50 mL/min flow, 70 mm Hg intraocular pressure, and 600 mm Hg vacuum. Cumulative dissipated energy (CDE) was noted. After euthanasia and enucleation, the corneas were removed, stained with trypan blue/alizarin red, and photographed in a standardized manner (×400 photographs from 5 specific areas and 1 overview photograph from each corneal button). The ImageJ program was used to evaluate cell damage and loss in the photographs.
CDE was 4.64 ± 0.19 for test eyes with beads and 4.66 ± 0.17 for control eyes without beads ( P = .58). The percentage of intact cells was statistically higher in the control group ( P = .0005), whereas the percentages of damaged and lost cells were statistically higher in the test group ( P = .0010 and .0005, respectively). This was observed in the analysis of the ×400 photographs and overview photographs.
This study suggests that lenticular debris swirling around the anterior chamber may cause significant damage to the corneal endothelium, providing further insight on mechanisms of damage during phacoemulsification.
评估在超声乳化过程中模拟晶状体碎片对角膜内皮细胞的机械损伤。
犹他州盐湖城的大学环境。
实验研究。
12 只新西兰兔接受了双侧手术。切口后，将 10 个 1.0mm 的珠子注入试验眼的前房，以模拟晶状体碎片。用相同的注射器将平衡盐溶液注入对侧眼。将 Centurion Ozil 手持件的 Intrepid 平衡尖端插入前房，以 50mL/min 的流量、70mmHg 的眼内压和 600mmHg 的真空施加 60%的扭转超声 20 秒。记录累积耗散能量（CDE）。安乐死后眼球取出，用台盼蓝/茜素红染色，以标准化方式拍照（每张角膜瓣来自 5 个特定区域的×400 张照片和 1 张全景照片）。使用 ImageJ 程序评估照片中细胞的损伤和丢失。
有珠子的试验眼的 CDE 为 4.64±0.19，无珠子的对照眼的 CDE 为 4.66±0.17（P=0.58）。对照组完整细胞的百分比统计学上更高（P=0.0005），而试验组受损和丢失细胞的百分比统计学上更高（P=0.0010 和 0.0005）。这在×400 张照片和全景照片的分析中都得到了观察。
这项研究表明，在眼前房内旋转的晶状体碎片可能会对角膜内皮细胞造成严重损伤，进一步了解超声乳化过程中的损伤机制。
