爆破模式联合软壳技术在复杂白内障的超声乳化术中应用观察

目的 探讨爆破超声模式联合软壳技术在复杂白内障患者的超声乳化吸出术中的临床效果.方法 38例（45眼）复杂白内障（青光眼术后角膜内皮细胞＜1500个/mm2或硬核Ⅳ～Ⅴ级,运用爆破模式超声乳化术,术中联合应用软壳技术保护角膜内皮细胞.记录术中所用的超声能量、有效超声时间及累积复合能量参数.并设对照组（脉冲模式）38例（45眼）.观察术后视力、角膜水肿程度、角膜内皮细胞密度及观察手术并发症.结果 试验组有效超声时间（22.44±13.2）s实际超声能量（14.37±5.84）%及累积复合能量参数（352.26±306.88）.对照组依次为（79.02±38.29）s,（25.44±8.34）%、（2402.97±2296.61）.两组经t检验差异有统计学意义（P＜0.01）.试验组术后1 d的角膜水肿程度为0～2级,术后1月的角膜上皮细胞损失率为9.35%,手术前、后比较无显著统计学意义（P＜0.5）.对照组依次为0～3级,31.19%,手术前、后比较有统计学意义（P＜0.01）.结论 爆破超声能量模式联合软壳技术能减轻眼内组织损伤,提高手术效果.

The application of burst and soft shell techniques in phacoemulsification for complicated cataract

Objective To discuss the clinical effect of burst technique and soft shell technique in phacoemulsification on complicated cataract. Methods Totally 38 cases (45 eyes) of complicated cataract were observed. The cataract were characterized as post-antiglaucoma surgery,hard nucleus of degree Ⅳ～ degree Ⅴ, and corneal endothelial cell counting less than 1500/mm2. Burst pattern was used in phacoemulsification,and soft shell technique was used for protecting endothelial cell during the surgery. The power,effect phaco time and cumulative compound power parameter were recorded. A control group of 38 cases (45 eyes)was made with pulse technique in Phaco. The vision, corneal edema, dense of corneal endothelial cell and complications were observed. Results The effect phaco time of experimental group was (22.44 ± 13.24) s,with an actual phaco power of ( 14.37 ± 5.84) % and cumulative compound power parameter of (353.26 ±306.88). The va; ie pf cpmtrp; group was ( 79.02 ± 38.29 ) s, ( 25.44 ± 8. 34 ) % and ( 2402.97 ±2296.61 ) respectively. There were statistically significant difference ( P ＜ 0. 01 ). The cornea edema of experimental group was degree 0 to degree 2 one day postoperatively. The rate of corneal endothelial cell loss was 9.35% one month after surgery. There was no statistically significant difference between the preoperative one and the postoperative one (P ＞0.05 ). That of control group was degree 0 ～ degree 3 and 31. 19% postoperatively,which was significantly different from the preoperative one (P ＜0. 01 ). Conclusion The technique of burst and soft shell could decrease intraocular injury and improve the surgery outcome.