Vajpayee R B, Sabarwal S, Sharma N, Angra S K
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi.
J Cataract Refract Surg. 1998 Sep;24(9):1252-5. doi: 10.1016/s0886-3350(98)80022-9.
To compare manual phacofracture and phacoemulsification techniques.
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India.
This prospective, randomized study comprised 60 cases of age-related cataract randomly divided into 2 groups: 30 eyes had phacoemulsification and 30, manual phacofracture using a trisection technique. Postoperative evaluation was at 1 day, 1 and 6 weeks, and 3 months. The parameters evaluated were amounts of viscoelastic material and irrigating fluid used, the time required to manage the nucleus, postoperative best corrected visual acuity, endothelial cell loss, and complications.
Mean viscoelastic material used intraoperatively (3.69 mL +/- 0.81 [SD] versus 1.76 +/- 0.54 mL) and the time required to manage the nucleus (7.78 +/- 2.07 minutes versus 2.53 +/- 1.18 minutes) were significantly greater in the phacofracture than in the phacoemulsification group, respectively. Best corrected visual acuity was significantly better in the phacoemulsification group on the first postoperative day; 64% had a visual acuity of 6/9 or better versus 37% in the phacofracture group. Endothelial cell loss at 3 months was 17.66 +/- 3.65% in the phacofracture group and 12.03 +/- 3.06% in the phacoemulsification group and central corneal edema persisting for more than 1 week, 7 and 0 cases, respectively. The differences between groups were statistically significant.
More experience in and further modification of the manual phacofracture technique are required before it can be recommended as a safe alternative to phacoemulsification.
比较手法碎核术和超声乳化术。
印度新德里拉金德拉·普拉萨德眼科科学中心。
这项前瞻性随机研究纳入60例年龄相关性白内障患者，随机分为2组：30眼行超声乳化术，30眼采用三分法行手法碎核术。术后评估时间点为术后1天、1周、6周和3个月。评估参数包括粘弹剂和灌注液用量、处理晶状体核所需时间、术后最佳矫正视力、内皮细胞丢失及并发症。
手法碎核术组术中平均粘弹剂用量（3.69 mL±0.81[标准差]对1.76±0.54 mL）和处理晶状体核所需时间（7.78±2.07分钟对2.53±1.18分钟）分别显著多于超声乳化术组。术后第1天超声乳化术组的最佳矫正视力显著更好；64%的患者视力达到6/9或更好，而手法碎核术组为37%。手法碎核术组3个月时内皮细胞丢失率为17.66±3.65%，超声乳化术组为12.03±3.06%，且中央角膜水肿持续超过1周的情况，手法碎核术组有7例，超声乳化术组为0例。两组间差异具有统计学意义。
在手法碎核术可被推荐为超声乳化术的安全替代方法之前，需要更多经验并进一步改进该技术。
