Application of active-fluidic pressure control phacoemulsification system in dense nuclear cataract

Jing XIE; Jiangning XU; Meifang LIU; Jiawen LI; Fuliang LI; Xi LIU

doi:10.16016/j.1000-5404.202102015

您当前的位置：

首页 >

文章列表页 >

Application of active-fluidic pressure control phacoemulsification system in dense nuclear cataract

Clinical Medicine | 更新时间：2026-01-09

- Application of active-fluidic pressure control phacoemulsification system in dense nuclear cataract
- Journal of Third Military Medical University Vol. 43, Issue 14, Pages: 1389-1395(2021)
- 作者机构：
  
  1.400038 重庆，陆军军医大学(第三军医大学)第一附属医院眼科
  2.401332 重庆，重庆市医药高等专科学校
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.202102015
  CLC： R181.32;R197.39;R779.66
- Received：02 February 2021，
  
  Revised：2021-03-31，
  
  Published：30 July 2021
- 稿件说明：
移动端阅览
Jing XIE, Jiangning XU, Meifang LIU, et al. Application of active-fluidic pressure control phacoemulsification system in dense nuclear cataract[J]. Journal of Third Military Medical University, 2021, 43(14): 1389-1395.
DOI：

Jing XIE, Jiangning XU, Meifang LIU, et al. Application of active-fluidic pressure control phacoemulsification system in dense nuclear cataract[J]. Journal of Third Military Medical University, 2021, 43(14): 1389-1395. DOI： 10.16016/j.1000-5404.202102015.

摘要

目的

对比主动控制液流系统和重力控制液流系统在硬核白内障超声乳化手术术中效率以及术后早期角膜水肿程度、中央角膜厚度变化、视力恢复的差异。

方法

纳入2020年1月至2020年12月就诊于本院眼科，且晶状体核硬度按照LOCS Ⅱ分级系统均属NⅣ级的年龄相关性白内障患者60例(60眼)，按照随机数字表法将患者分成主动控制液流系统组(主控组)及重力控制液流系统组(重力组)。主控组: 术中应用主动控制液流系统行白内障超声乳化吸除联合人工晶体植入手术30例(30眼)；重力组: 术中应用重力控制液流系统行白内障超声乳化吸除联合人工晶体植入手术30例(30眼)。记录每例患者术中所用累计释放能量(cumulative dissipated energy

CDE)、总超声乳化时间(ultrasound total time，UTT)、扭动能量振幅(torsional amplitude

TA)、扭动超声使用时间(torsion use time

TUT)、抽吸时间(aspiration time

AT)、液流使用量(fluid use

FU)。术后评价指标包括术后第1天裸眼远视力、中央角膜水肿程度及中央角膜厚度(central corneal thickness

CCT)。

结果

术前两组患者的最佳矫正远视力、中央角膜厚度、角膜内皮细胞计数组间差异均无统计学意义。主控组的CDE、UTT、TUT、AT、FU均显著少于重力组(

0.05)，而两组之间TA差异无统计学意义。术后1 d两组病例CCT差异均无统计学意义。主控组裸眼远视力显著优于重力组(

=0.005)。术后1 d主控组CCT增加幅度显著低于重力组(

=0.006)，主控组中央角膜水肿程度显著低于重力组(

0.001)，主控组中重度中央角膜水肿患者比例显著低于重力组(

0.001)。

结论

主动控制液流系统相对于传统重力系统对硬核白内障患者具有更高的超声乳化手术效率，患者术后早期角膜水肿程度更轻，角膜厚度变化更小，术后早期视力恢复更快。

Abstract

Objective

To compare the surgical efficiency and postoperative evaluation indicators between active-fluidic pressure control phacoemulsification system and gravity-fluidics in dense nuclear cataract surgery.

Methods

A total of 60 patients (60 eyes) with age-related cataract admitted in the First Affiliated Hospital of Army Medical University from January 2020 to December 2020 were enrolled in this prospective study

and all of them were classified as NⅣ grade according to the Lens Opacities Classification System Ⅱ (LOCS Ⅱ). They were randomized into the active-fluidics group (

=30

phacoemulsification by active-fluidic pressure control system) or the gravity-fluidics group (

=30

phacoemulsification by gravity-fluidic system). Intraoperative parameters

such as cumulative dissipated energy (CDE)

ultrasound total time (UTT)

torsional amplitude (TA)

torsion usage time (TUT)

aspiration time (AT)

and fluid used (FU) were recorded and compared between the 2 groups. Postoperative evaluation indicators

like central corneal thickness (CCT)

central corneal edema and thickness (CCT) at 1 d after surgery were also collected and compared.

Results

There were no significant differences in preoperative bes

t corrected distance visual acuity

CCT

and corneal endothelial cell count between the 2 groups. Intraoperatively

the active-fluidics group had significantly lower CDE

UTT

TUT

AT and FU than the gravity-fluidics group (

0.05)

though TA did not differ. Moreover

the active-fluidics group also presented better UDVA (

=0.005)

less increase of CCT (

=0.006)

slighter central corneal edema (

0.001)

and smaller proportion of patients with moderate to severe central corneal edema (

0.001) than the gravity-fluidics group in 1 d after surgery.

Conclusion

The active-fluidics configuration achieves a higher surgical efficiency than the traditional gravity-fluidics system in phacoemulsification of dense nuclear cataract

with slighter postoperative corneal edema

less change of CCT and faster recovery of UDVA.

关键词

Keywords

references

DAVIDORF J M. Femtosecond versus (gold) standard phacoemulsification[J]. J Cataract Refract Surg, 2015, 41(5): 1124. DOI:10.1016/j.jcrs.2015.03.014.

韩钰, 王军. 微小切口白内障手术新进展[J]. 中华眼科杂志, 2012, 48(4): 369-373.

HAN Y, WANG J. New progresses in micro-incision cataract surgery[J]. Chin J Ophthalmol, 2012, 48(4): 369-373.

GEORGESCU D, KUO A F, KINARD K I, et al . A fluidics comparison of Alcon Infiniti, Bausch & Lomb Stellaris, and Advanced Medical Optics Signature phacoemulsification machines[J ] . Am J Ophthalmol, 2008, 145(6): 1014-1017. DOI:10.1016/j.ajo.2008.01.024.

GEORGESCU D, PAYNE M, OLSON R J. Objective measurement of postocclusion surge during phacoemulsification in human eye-bank eyes[J]. Am J Ophthalmol, 2007, 143(3): 437-440. DOI:10.1016/j.ajo.2006.11.017.

MALIK P K, DEWAN T, PATIDAR A K, et al . Effect of IOP based infusion system with and without balanced phaco tip on cumulative dissipated energy and estimated fluid usage in comparison to gravity fed infusion in torsional phacoemulsification[J ] . Eye Vis (Lond), 2017, 4: 22. DOI:10.1186/s40662-017-0087-5.

谢晶, 徐江宁, 刘美芳, 等. 主动控制液流系统应用于原发性闭角型青光眼白内障超声乳化术的临床研究[J]. 第三军医大学学报, 2020, 42(21): 2141-2147. DOI:10.16016/j.1000-5404.202008072.

XIE J, XU J N, LIU M F, et al . Application of active-fluidic pressure control phacoemulsification system for primary angle-closure glaucoma with cataract: reports of 24 cases[J ] . J Third Mil Med Univ, 2020, 42(21): 2141-2147. DOI:10.16016/j.1000-5404.202008072.

CHRISTAKIS P G, BRAGA-MELE R M. Intraoperative performance and postoperative outcome comparison of longitudinal, torsional, and transversal phacoemulsification machines[J]. J Cataract Refract Surg, 2012, 38(2): 234-241. DOI:10.1016/j.jcrs.2011.08.035.

HAN Y K, MILLER K M. Heat production: Longitudinal versus torsional phacoemulsification[J]. J Cataract Refract Surg, 2009, 35(10): 1799-1805. DOI:10.1016/j.jcrs.2009.04.046.

FOSTER G J L, ALLEN Q B, AYRES B D, et al . Phacoemulsification of the rock-hard dense nuclear cataract: options and recommendations[J ] . J Cataract Refract Surg, 2018, 44(7): 905-916. DOI:10.1016/j.jcrs.2018.03.038.

MENCUCCI R, PONCHIETTI C, VIRGILI G, et al . Corneal endothelial damage after cataract surgery: microincision versus standard technique[J ] . J Cataract Refract Surg, 2006, 32(8): 1351-1354. DOI:10.1016/j.jcrs.2006.02.070.

NIXON D R. Preoperative cataract grading by Scheimpflug imaging and effect on operative fluidics and phacoemulsification energy[J]. J Cataract Refract Surg, 2010, 36(2): 242-246. DOI:10.1016/j.jcrs.2009.08.032.

CHO Y K, CHANG H S, KIM M S. Risk factors for endothelial cell loss after phacoemulsification: comparison in different anterior chamber depth groups[J]. Korean J Ophthalmol, 2010, 24(1): 10-15. DOI:10.3341/kjo.2010.24.1.10.

DICK H B, KOHNEN T, JACOBI F K, et al . Long-term endothelial cell loss following phacoemulsification through a temporal clear corneal incision[J ] . J Cataract Refract Surg, 1996, 22(1): 63-71. DOI:10.1016/s0886-3350(96)80272-0.

CHEN M, ANDERSON E, HILL G, et al . Comparison of cumulative dissipated energy between the Infiniti and Centurion phacoemulsification systems[J ] . Clin Ophthalmol, 2015, 9: 1367-1372. DOI:10.2147/OPTH.S88225.

SOLOMON K D, LORENTE R, FANNEY D, et al . Clinical study using a new phacoemulsification system with surgical intraocular pressure control[J ] . J Cataract Refract Surg, 2016, 42(4): 542-549. DOI:10.1016/j.jcrs.2016.01.037.

SHARIF-KASHANI P, FANNEY D, INJEV V. Comparison of occlusion break responses and vacuum rise times of phacoemulsification systems[J]. BMC Ophthalmol, 2014, 14: 96. DOI:10.1186/1471-2415-14-96.

REUSCHEL A, BOGATSCH H, BARTH T, et al . Comparison of endothelial changes and power settings between torsional and longitudinal phacoemulsification[J ] . J Cataract Refract Surg, 2010, 36(11): 1855-1861. DOI:10.1016/j.jcrs.2010.06.060.

HO J W, AFSHARI N A. Advances in cataract surgery: preserving the corneal endothelium[J]. Curr Opin Ophthalmol, 2015, 26(1): 22-27. DOI:10.1097/ICU.0000000000000121.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Application of active-fluidic pressure control phacoemulsification system for primary angle-closure glaucoma with cataract: reports of 24 cases

Clinical analysis of phacoemulsification on patients with cardiovascular disease

Related Author

谢晶

徐江宁

刘美芳

李嘉文

刘玺

陈鹏

贺翔鸽

Related Institution

No data

⁰