Chukyo Eye Clinic, Nagoya, Aichi, Japan.
General Aoyama Hospital, Toyokawa, Aichi, Japan.
PLoS One. 2023 Aug 29;18(8):e0290657. doi: 10.1371/journal.pone.0290657. eCollection 2023.
Phacoemulsification has emerged as the global standard for cataract surgery, and various novel methods, tools, and agents have promoted surgical efficiency and reduced complications. Conventionally, the phaco tip, which cleaves and aspirates the cataractous lens, has been mainly constructed of metal. In this study, the risk of anterior capsule rupture was evaluated under conditions of different power modes, longitudinal (Mode-L), torsional (Mode-T), or both (Mode-LT), and different aspiration powers (0 or 200 mmHg), using a traditional metal phaco tip (Group-M) or a new phaco tip with a high-strength polymer overmold on the needle edge (Group-P), which was developed to reduce the risk of capsule rupture. One hundred twenty porcine eyes were used for experiments within a setting of typical human physiological intraocular pressure. We found that Group-M showed capsule rupture with a smaller ultrasound power than did Group-P, regardless of power mode or aspiration power. In Group-M, there was no significant difference in risk of capsule rupture among power modes, however in Group-P, capsule rupture was least likely to occur with Mode-T. These results provide useful information for inexperienced ophthalmologists to improve surgical safety.
超声乳化已成为全球白内障手术的标准,各种新方法、工具和制剂提高了手术效率并减少了并发症。传统上,用于切割和抽吸白内障晶状体的超声乳化针头主要由金属制成。在本研究中,使用传统的金属超声乳化针头(组-M)或新的在针头边缘有高强度聚合物包层的超声乳化针头(组-P),评估了不同功率模式(纵向模式-Mode-L、扭转模式-Mode-T 或混合模式-Mode-LT)和不同抽吸功率(0 或 200mmHg)下的前囊破裂风险。在典型的人眼生理眼压环境下,用 120 只猪眼进行实验。我们发现,无论功率模式或抽吸功率如何,组-M 均比组-P 显示出更小超声功率时的囊破裂。在组-M 中,不同功率模式之间的囊破裂风险无显著差异,但在组-P 中,囊破裂发生风险最小的是 Mode-T。这些结果为经验不足的眼科医生提供了有用的信息,以提高手术安全性。