不同眼压设定下使用主动哨兵和主动射流的超声乳化安全性和预后 - 一项随机对照研究。

Safety and prognosis of phacoemulsification using active sentry and active fluidics with different IOP settings - a randomized, controlled study.

机构信息

Yantai Aier Eye Hospital, Yantai, China.

Department of Ophthalmology, Affiliated Qingdao Third People's Hospital, Qingdao University, Qingdao, China.

出版信息

BMC Ophthalmol. 2024 Aug 16;24(1):350. doi: 10.1186/s12886-024-03626-z.

DOI:10.1186/s12886-024-03626-z

PMID:39152387

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11330061/

Abstract

PURPOSE

To explore the impact of different intraoperative intraocular pressure (IOP) settings on the safety and prognosis in phacoemulsification.

METHODS

Age related cataract patients who met the inclusion criteria and underwent phacoemulsification by using active sentry handpiece and active fluidics system. According to different intraoperative IOP settings during surgery, they were randomly divided into two groups: the 20mmHg group and the 60mmHg group. The best corrected visual acuity (BCVA), cumulative dissipated energy (CDE), total U/S time, active surge mitigation (ASM), estimated fluid usage (EFU) as well as the changes in corneal thickness (CT), corneal epithelial layer thickness (CELT) and endothelial cell density (ECD) were collected. The post-operative follow-up was only 1 day.

RESULTS

A total of 110 cases (110 eyes) were included in the study. There were 55 eyes in each group. There was no statistically significant difference in postoperative BCVA (p = 0.839). The CDE, total U/S time and EFU during surgery were (5.22 ± 3.31), (30.60 ± 15.06), (45.07 ± 12.68) and (4.70 ± 2.83), (27.39 ± 13.75), (42.38 ± 11.93) in the 20mmHg group and 60mmHg group (p = 0.381, 0.246, 0.254). The ASM during surgery in the 20mmHg group and 60mmHg group were (0.95 ± 2.77) and (7.24 ± 6.34), respectively. The 20mmHg group showed a significant decrease in ASM (p < 0.001). There was no statistically significant difference in the changes in CT, CELT and ECD before and after surgery between the two groups (p = 0.913, 0.825, 0.624). Both groups did not experience any intraoperative complications, such as posterior capsule rupture.

CONCLUSION

A lower IOP setting of 20 mmHg can significantly reduce the occurrence of intraoperative surges during phacoemulsification. And there was no increase in rate of complications.

TRIAL REGISTRATION

The trial registration number is ChiCTR2100050240. The registered date is August 24th, 2021.

摘要

目的

探讨不同术中眼内压（IOP）设定对白内障超声乳化术中安全性和预后的影响。

方法

纳入符合条件并采用主动监护仪手柄和主动流控系统行白内障超声乳化术的年龄相关性白内障患者。根据术中不同的 IOP 设置，将其随机分为两组：20mmHg 组和 60mmHg 组。收集最佳矫正视力（BCVA）、累积耗散能量（CDE）、总超声时间、主动涌流缓解（ASM）、估计液量（EFU）以及角膜厚度（CT）、角膜上皮层厚度（CELT）和内皮细胞密度（ECD）的变化。术后随访仅 1 天。

结果

共纳入 110 例（110 眼）患者。每组各 55 例。术后 BCVA 无统计学差异（p=0.839）。20mmHg 组和 60mmHg 组术中 CDE、总超声时间和 EFU 分别为（5.22±3.31）、（30.60±15.06）、（45.07±12.68）和（4.70±2.83）、（27.39±13.75）、（42.38±11.93）（p=0.381、0.246、0.254）。20mmHg 组和 60mmHg 组术中 ASM 分别为（0.95±2.77）和（7.24±6.34）。20mmHg 组 ASM 显著降低（p<0.001）。两组术后 CT、CELT 和 ECD 变化无统计学差异（p=0.913、0.825、0.624）。两组均未发生术中后囊破裂等并发症。