摘要
目的：比较双轴灌注抽吸（IA）与同轴IA在白内障超声乳化中抽吸皮质的临床效果，探讨双轴IA系统的安全性及有效性。方法：前瞻性研究。收集2014 年10 月至2016 年9 月期间在安徽医科大学附属合肥医院就诊的年龄相关性白内障患者60 例，依据不同皮质注吸方式分为同轴IA组（30 眼）和双轴IA组（30 眼），同轴IA组采用传统两切口，主切口同轴灌注抽吸皮质；双轴IA组采用三切口，主切口超声乳化，2个相反方向的侧切口交替灌注抽吸。常规水分离，超声乳化晶状体状核，分别利用同轴和双轴IA注吸晶状体皮质，术中记录抽吸皮质时间，前房涌动、皮质残留以及后囊破裂发生率，术后1 周、1 个月后观察视力、角膜散光变化。采用秩和检验，Pearson卡方检验以及Fisher＇s精确检验进行数据分析。结果：同轴IA组平均皮质吸出时间为（150±16）s，双轴IA组平均皮质吸出时间为（118±10）s，两者比较差异有统计学意义（Z=-6.174，P 〈 0.001）。同轴IA组皮质一次性吸除的成功率为57%，双轴IA组无前房涌动，皮质一次完全吸除成功率为100%；同轴IA组与双轴IA组术后视力及散光变化差异均无统计学意义。同轴IA组1 例后囊破裂。结论：与同轴IA相比，双轴IA抽吸皮质时间更短，具有更好的安全性及有效性。
Objective： To evaluate the clinical results of cortex removal with biaxial irrigation and aspiration （IA） compared with coaxial IA in phacoemulsification. Methods： This prospective study enrolled cataract patients who underwent phacoemulsification and intraocular lens implantation at the Second People＇s Hospital of Hefei Affiliated to Anhui Medical University. The patients were divided into two groups （each with 30 patients, 30 eyes） based on the cortex removal mode： biaxial IA and coaxial IA. For the biaxial IA group, we made three corneal incisions： one main incision at 12？？00 （phaco tip） and two side port incisions at 3？？00 and 9？？00 （irrigation and aspiration）. For the coaxial IA group, we made one main incision and one side port incision at mutually perpendicular lines. In both groups, normal hydrodissection was set and the nucleus was aspirated with ultrasound phacoemulsification energy. The residual cortex was removed, and posterior capsule polishing was performed using either biaxial IA or coaxial IA. The time （in seconds） required for the removal of the cortex measured from instrument insertion in the eye until aspiration tip removal. Residual cortex, posterior capsule ruptures, visual acuity, and corneal astigmatism were recorded.Data were analyzed by the Mann-Whitney test, chi-square test, and Fisher＇s exact test. Results： The cortex removal time was 118 ± 10 seconds for the biaxial IA group and 150 ± 16 seconds for the coaxial IA group （Z=-6.174, P〈0.001）. Compared to coaxial IA, biaxial IA resulted in more stability of the anterior chamber and more effective cortex removal, the success rate of one-off suction in coaxial IA group and biaxial IA group were 57% and 100% respectively. There were no significant differences in visual acuity or corneal astigmatism between the two groups （P〉0.05）. One posterior capsular tear occurred in the coaxial IA group. Conclusions： Biaxial IA significantly reduced cortex removal time compared to coaxial IA. Biaxial IA appears to be safer and more efficient than coaxial IA in cortex removal.
作者
纪风涛
李永蓉
孙文娟
Fengtao Ji;Yongrong Li;Wenjuan Sun(Department of Ophthalmology, the Second People＇s Hospital of Hefei Affiliated to Anhui Medical University, Hefei 230001, China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2018年第4期232-236,共5页
Chinese Journal Of Optometry Ophthalmology And Visual Science
关键词
灌注抽吸
皮质
双轴
超声乳化
irrigation/aspiration
cortex
biaxial
phacoemulsification
作者简介
纪风涛（ORCID：0000-0002-7340-0668），Email：wfjft@sina.com;通讯作者： 李永蓉（ORCID：0000-0001-9559-9025），Email：Tiger9611@126.com
