Department of Ophthalmology, Command Hospital (Eastern Command), Kolkata, India.
Department of Anaesthesia, Command Hospital (Eastern Command), Kolkata, India.
Rom J Ophthalmol. 2024 Jul-Sep;68(3):287-293. doi: 10.22336/rjo.2024.52.
Phacoemulsification is the predominant method for cataract surgery, but complications like lens nuclei dislodgment into the vitreous cavity pose significant risks, including inflammation, glaucoma, retinal tears, and vision loss. Traditional management involves pars plana vitrectomy with phacofragmentation, which can increase the risk of retinal damage due to repulsive forces. This study tests whether the OZil phacoemulsification handpiece, employing torsional movement, offers a safer alternative by minimizing repulsive forces and reducing surgical duration compared to the traditional phacofragmatome.
This prospective study, conducted in a tertiary care hospital in eastern India from January to June 2023, enrolled 40 patients with nucleus dislocation during cataract surgery. Patients were randomized into Group 1 (traditional phacofragmatome) and Group 2 (OZil handpiece). Primary objectives included comparing the duration of surgery and intraoperative complications. Secondary objectives assessed postoperative best-corrected visual acuity (BCVA), surgical site safety, and cystoid macular edema (CME) incidence.
Group 2 demonstrated significantly shorter surgical durations (110±2.54 seconds) compared to Group 1 (152±2.23 seconds, p < 0.001). The frequency of nucleus falls was considerably lower in Group 2 (p < 0.001). Postoperative BCVA and CME incidence showed no significant differences between groups. Multiple regression analysis confirmed the OZil handpiece significantly reduced surgical duration (β = -0.40, p < 0.001) without compromising safety.
The OZil handpiece's rotational cutting mechanism offers a significant advantage in reducing surgical time while improving the followability of lens fragments, as compared to the traditional phacofragmatome. It addresses one of the key limitations of phacofragmentation by minimizing fragment displacement, where repulsive forces can complicate the procedure. Although both techniques showed similar safety profiles, the OZil handpiece's operational efficiency makes it a promising alternative for managing posteriorly displaced lens fragments in complex cases.
The OZil phacoemulsification handpiece significantly enhances surgical efficiency and safety in nucleus drop surgeries. Its integration into existing phacofragmatome systems can lead to major advancement in the ophthalmic surgical armamentarium, ensuring improved patient care.
超声乳化术是白内障手术的主要方法，但晶状体核脱位进入玻璃体腔等并发症会带来严重风险，包括炎症、青光眼、视网膜裂孔和视力丧失。传统的治疗方法包括经睫状体平坦部玻璃体切除术联合超声粉碎术，但由于斥力的存在，可能会增加视网膜损伤的风险。本研究旨在测试采用扭转运动的 OZil 超声乳化手柄是否通过最小化斥力并缩短手术时间，相对于传统的超声粉碎刀而言，是一种更安全的替代方法。
本前瞻性研究于 2023 年 1 月至 6 月在印度东部的一家三级护理医院进行，共纳入 40 例白内障手术中晶状体核脱位的患者。患者随机分为 1 组（传统超声粉碎刀）和 2 组（OZil 手柄）。主要研究目标包括比较手术时间和术中并发症。次要研究目标评估术后最佳矫正视力（BCVA）、手术部位安全性和囊样黄斑水肿（CME）的发生率。
2 组的手术时间明显缩短（110±2.54 秒比 152±2.23 秒，p<0.001）。2 组的晶状体核脱落频率明显降低（p<0.001）。两组术后 BCVA 和 CME 发生率无显著差异。多元回归分析证实，OZil 手柄显著缩短了手术时间（β=-0.40，p<0.001），同时不影响安全性。
与传统的超声粉碎刀相比，OZil 手柄的旋转切割机制具有显著优势，可减少手术时间，同时改善晶状体碎片的跟随性。它通过最小化碎片移位来解决超声粉碎术的一个关键局限性，在该过程中，斥力会使手术复杂化。虽然两种技术的安全性相似，但 OZil 手柄的操作效率使其成为处理复杂病例中后脱位晶状体碎片的一种有前途的替代方法。
OZil 超声乳化手柄显著提高了晶状体核脱位手术的手术效率和安全性。将其集成到现有的超声粉碎刀系统中，可以使眼科手术设备得到重大改进，从而改善患者的治疗效果。
