Ricks Reiker G, Cardenas Ivan A, Jensen Jenna L, Nelson Tanner K, Olson Randall J, Pettey Jeff H
Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah, Salt Lake City, UT, 84132, USA.
University of Utah School of Medicine, Salt Lake City, UT, 84132, USA.
Med Devices (Auckl). 2024 Oct 17;17:339-348. doi: 10.2147/MDER.S484843. eCollection 2024.
This study aims to investigate the differences between the heat energy produced during cataract surgery and Cumulative dissipated energy (CDE). CDE is often used as a medium for understanding the energy delivered to the eye during cataract surgery. However, the actual energy produced at the tip level of the tip is not well understood. We propose that a discrepancy may exist between the CDE reported by the surgical machine and the actual energy delivered to the eye.
About 50 mL of distilled water were degassed and placed in an isobaric calorimeter. Using the Alcon Centurion and Ozil handpiece fitted with the balanced tip, an investigator immersed the phaco tip into the water and pressed the foot pedal to position 3. The device was set to 100% continuous power, vacuum to 0 mmHg, with aspiration 12 mL/min aspiration. To prevent system changes in the system within the calorimeter, the aspiration tubing was occluded. Temperature change recorded by another investigator was observed from 0 to 60 seconds. After 60 seconds the first researcher immediately released the pedal and removed the phaco tip from the water. Trials were performed 10 times using solely torsional or longitudinal settings and averaged. CDE also was recorded and averaged.
No significant difference was seen in the temperature change or energy calculated in Joules between ultrasound modalities, with torsional producing a magnitude of 163 J and longitudinal producing 172 J (P = 0.2). However, the CDE generated in the 60 seconds period was significantly different, with a magnitude of 61 for longitudinal compared to 24 for torsional (P < 0.001).
Significantly more energy was generated using torsional ultrasound than longitudinal at the tip level of the tip. CDE did not appear to accurately reflect these differences. This suggests that other factors should be considered when evaluating CDE and surgical outcomes.
本研究旨在调查白内障手术过程中产生的热能与累积耗散能量（CDE）之间的差异。CDE常被用作理解白内障手术中传递至眼睛的能量的一种媒介。然而，在超声乳化头尖端水平实际产生的能量尚不清楚。我们提出手术机器报告的CDE与实际传递至眼睛的能量之间可能存在差异。
将约50 mL蒸馏水脱气后置于等压热量计中。一名研究者使用配备平衡型尖端的爱尔康Centurion和奥西（Ozil）超声乳化手柄，将超声乳化头浸入水中并将脚踏板踩至位置3。设备设置为100%连续功率，真空度为0 mmHg，抽吸速率为12 mL/min。为防止热量计内系统发生变化，抽吸管道被堵塞。另一名研究者观察并记录0至60秒的温度变化。60秒后，第一名研究者立即松开踏板并将超声乳化头从水中取出。仅使用扭转或纵向设置进行10次试验并求平均值。同时记录并求平均CDE。
不同超声模式下的温度变化或计算得出的以焦耳为单位的能量未见显著差异，扭转模式产生的能量为163 J，纵向模式产生172 J（P = 0.2）。然而，60秒内产生的CDE存在显著差异，纵向模式下为61，扭转模式下为24（P < 0.001）。
在超声乳化头尖端水平，使用扭转超声产生的能量明显多于纵向超声。CDE似乎并未准确反映这些差异。这表明在评估CDE和手术结果时应考虑其他因素。
