摘要
目的对比主控系统和重力系统对原发性闭角型青光眼患者白内障超声乳化手术术中效率及术后中央角膜厚度、眼压及角膜内皮细胞计数的影响。方法收集2016年6月至2019年12月就诊于陆军军医大学第一附属医院眼科24例(48眼)原发性闭角型青光眼合并白内障患者,使用Centurion视觉系统超声乳化仪手术。主控组24例24眼,患者一眼应用主动液流控制系统;重力组24例24眼,患者另一眼应用传统重力灌注系统。记录术中效率及术后1 d、1周、1个月角膜内皮细胞密度、眼压及中央角膜厚度变化。结果术前两组患者的基本资料差异无统计学意义。主控组的总超声乳化时间、扭动超声使用时间、抽吸时间和液流使用量显著低于重力组(P<0.05)。累计释放能量和扭动能量振幅两组无统计学差异。术后1 d、1周主控组的中央角膜厚度和眼压的变化程度低于重力组(P<0.01)。术后1个月两组均无统计学差异。术后1 d、1周、1个月两组病例角膜内皮细胞丢失降低程度无统计学差异。结论Centurion Vision System主控系统相对于传统重力控制系统有更高的超声乳化手术效率,能保证原发性闭角型青光眼患者术后早期非接触眼压测量的准确性。
Objective To compare the intraoperative efficacies of active-fluidic pressure control phacoemulsification system versus gravity-fluidics on intraoperative efficiency for primary angle-closure glaucoma with cataract,and investigate their effects on postoperative central corneal thickness(CCT),intraocular pressure(IOP),and count of corneal endothelial cells.Methods A total of 24 patients(48 eyes)with primary angle-closure glaucoma and also accompanied with cataract undergoing surgical treatment in our ophthalmology department from June 2016 to December 2019 were prospectively recruited in this study.With the aid of Alcon Centurion Phacoemulsification Vision System,these patients underwent phacoemulsification with active-fluidics configuration in one eye(active group),and with gravity-fluidics configuration in another eye(gravity group).Their intraoperative parameters,such as cumulative dissipated energy(CDE),total ultrasound(US)time,torsion use time,torsion amplitude,aspiration time,and fluid use,were noted and compared between configurations.Endothelial cell loss,and CCT and IOP changes were evaluated at 1 d,1 week,and 1 month postoperatively.Results There were no significant differences in the baseline data between the 2 groups.The active group had significantly shorter total US time,torsion use time and aspiration time,and lower amount of fluid use than the gravity group(P<0.05).But no statistical differences were seen in the phacoemulsification energy and torsion amplitude between them.The active-fluidics configuration showed significantly less changes in CCT and IOP at 1 day and 1 week postoperatively than the gravity-fluidics configuration(P<0.01).But such differences were disappeared in 1 month later.There was no notable difference in the loss of endothelial cells at all time points between the 2 groups.Conclusion The active-fluidics configuration achieve higher surgical efficiency than the gravity-fluidics configuration for angle-closure glaucoma eyes with coexisting cataract,and can guarantee the accuracy of IOP in early stage after surgery.
作者
谢晶
徐江宁
刘美芳
李嘉文
刘玺
XIE Jing;XU Jiangning;LIU Meifang;LI Jiawen;LIU Xi(Department of Ophthalmology,First Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,400038;Chongqing Medical and Pharmaceutical College,Chongqing,401331,China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2020年第21期2141-2147,共7页
Journal of Third Military Medical University
关键词
主动液流控制系统
重力液流控制系统
原发性闭角型青光眼
白内障超声乳化术
眼压
active-fluidic pressure control phacoemulsification system
gravity-fluidics pressure control phacoemulsification system
primary angle-closure glaucoma
phacoemulsification
intraocular pressure
