Girard L J, Nieves R, Hawkins R S
Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1976 May-Jun;81(3 Pt 1):432-50.
Ultrasonic fragmentation (USF) can be used to fragment various tissues such as the lens, the vitreous, the iris, and the ciliary body, so that they may be aspirated through a 23-gauge canula. Since the technique was first described in 1973, it has been used in 148 eyes in a variety of conditions with encouraging results. In aphakic bullous keratopathy, the corneas and vision improved in 78% of the cases. Pupillary block was relieved in 100% of cases. Cystoid macular edema improved in 63%. Vitreous opacification from other than hemorrhage cleared in all cases, and vision improved in 71%. Massive vitreous hemorrhage was cleared in 86%, and vision improved in 58%. In massive vitreous hemorrhage and retinal detachment, the vitreous was cleared and the retina reattached in 80% of cases. In massive vitreous contraction, the vitreous was removed in all cases and the retina reattached in all (100%) of cases. In massive vitreous membranes and retinal detachment, the membranes were successfully removed in 100% and the retina reattached in 82%. Lens remnants in the vitreous were removed in 100% of cases. Secondary membranes were removed successfully in 100% of cases. Vitreous presentation in the anterior chamber, caused by a ruptured posterior capsule during extracapsular extraction or actual vitreous loss during intracapsular extraction, was treated successfully in 100% of cases. One case of medullo-epithelioma of the ciliary body was removed but recurred twice after ultrasonic fragmentation. Complications occurred in seven of 148 cases (4.8%) and consisted of five cases of retinal detachment (probably because of lens material reaction) and two cases of epithelial downgrowth in cases where the wound was not closed with sutures. Ultrasonic fragmentation appears to be a fairly simple procedure, performed with a machine with no moving parts, through two 1-mm incisions and using two 0.6-mm cannulas, with a minimum of complications and encouraging results. It should be tried before more radical procedures are recommended. A good anatomic result was obtained in 129 of the 148 consecutive cases (88%). The technique is described and the results reported.
超声粉碎术（USF）可用于粉碎各种组织，如晶状体、玻璃体、虹膜和睫状体，以便通过23号套管将其吸出。自1973年首次描述该技术以来，它已被用于148只眼睛的各种病症，效果令人鼓舞。在无晶状体大泡性角膜病变中，78%的病例角膜和视力得到改善。100%的病例瞳孔阻滞得到缓解。63%的病例黄斑囊样水肿有所改善。除出血外的其他玻璃体混浊在所有病例中均消失，71%的病例视力得到改善。86%的大量玻璃体出血得到清除，58%的病例视力得到改善。在大量玻璃体出血和视网膜脱离病例中，80%的病例玻璃体被清除且视网膜复位。在大量玻璃体收缩病例中，所有病例的玻璃体均被切除，所有（100%）病例的视网膜均复位。在大量玻璃体膜和视网膜脱离病例中，100%的病例成功切除了膜，82%的病例视网膜复位。100%的病例清除了玻璃体内的晶状体残余物。100%的病例成功切除了继发性膜。对于囊外摘除术中后囊破裂或囊内摘除术中实际玻璃体丢失导致的前房玻璃体脱出，100%的病例治疗成功。1例睫状体髓上皮瘤经超声粉碎术切除，但术后复发两次。148例中有7例（4.8%）出现并发症，包括5例视网膜脱离（可能是由于晶状体物质反应）和2例伤口未缝合时的上皮内生。超声粉碎术似乎是一个相当简单的操作，使用一台无活动部件的机器，通过两个1毫米切口并使用两个0.6毫米套管进行，并发症最少且效果令人鼓舞。在推荐更激进的手术之前应尝试该方法。在连续的148例病例中，129例（88%）获得了良好的解剖学结果。本文描述了该技术并报告了结果。
