Kohlhaas M, Walter A
Universitäts-Augenklinik Hamburg-Eppendorf.
Ophthalmologe. 1998 Jul;95(7):478-81. doi: 10.1007/s003470050300.
The endothelial cell count after phacoemulsification serves as a sensitive indicator for the level of corneal traumatization caused by different phacoemulsification techniques concerning the used phacotime and phacoenergy/s.
In a prospective and randomized study, the "reversed tip and snip" technique and the "divide and conquer" technique were performed in groups of 30 patients each. The corneal endothelial cell count was measured preoperatively as well as 4 weeks and 3 months postoperatively. In a second study the phacotime and phacoenergy used/second and the endothelial cell loss were compared between patients 1-30 and 31-60 who were operated on with the "reversed tip and snip" technique, demonstrating the learning curve of this technique.
The endothelial cell count showed significant (P < 0.001) reduction by about 10% after the "reversed tip and snip" technique and by about 15% after the "divide and conquer" technique. The latter produced significantly greater cell loss. The phacotime (mean: 22-17) and phacoenergy/s (mean: 23-16) were reduced significantly (P < 0.05) when patients 1-30 were compared with 31-60.
The "reversed tip and snip" phacoemulsification technique produces less endothelial cell loss than the "divide and conquer" technique. There is a short learning curve by using the "reversed tip and snip" technique.
白内障超声乳化术后的内皮细胞计数可作为一种敏感指标，用于评估不同超声乳化技术在使用超声乳化时间和超声能量时对角膜造成的损伤程度。
在一项前瞻性随机研究中，分别对每组30例患者实施“翻转头端剪切”技术和“分而治之”技术。术前以及术后4周和3个月测量角膜内皮细胞计数。在第二项研究中，比较了采用“翻转头端剪切”技术进行手术的1至30号患者和31至60号患者之间的超声乳化时间、每秒使用的超声能量以及内皮细胞损失情况，以此展示该技术的学习曲线。
“翻转头端剪切”技术后内皮细胞计数显著降低（P < 0.001），约降低10%；“分而治之”技术后内皮细胞计数约降低15%。后者导致的细胞损失显著更大。将1至30号患者与31至60号患者进行比较时，超声乳化时间（均值：22 - 17）和每秒超声能量（均值：23 - 16）显著降低（P < 0.05）。
“翻转头端剪切”超声乳化技术比“分而治之”技术导致的内皮细胞损失更少。使用“翻转头端剪切”技术存在较短的学习曲线。
