Yu N Yusef, S N Yusef, A S Vvedenskiy, M N Ivanov, L Alkharki, N D Fokina
{"title":"[飞秒激光辅助晶状体核破碎模式对超声乳化能量和流体力学参数的影响]。","authors":"Yu N Yusef, S N Yusef, A S Vvedenskiy, M N Ivanov, L Alkharki, N D Fokina","doi":"10.17116/oftalma2024140022129","DOIUrl":null,"url":null,"abstract":"<p><p>The influence of various patterns of preliminary femtosecond laser-assisted fragmentation of the lens nucleus on the energy and hydrodynamic parameters of phacoemulsification remains insufficiently studied.</p><p><strong>Purpose: </strong>This study evaluates the influence of various patterns of preliminary femtosecond laser-assisted fragmentation of the lens nucleus on the energy, hydrodynamic parameters of phacoemulsification, and the degree of corneal endothelial cell loss.</p><p><strong>Material and methods: </strong>Hybrid phacoemulsification was performed in 336 patients (336 eyes) with grade IV immature cataract according to the Buratto classification in three age-matched groups. Group 1 included 103 patients (103 eyes) who underwent hybrid phacoemulsification with preliminary femtosecond laser-assisted fragmentation of the nucleus with a «pizza» pattern (division of the nucleus with 10 radial cuts). Group 2 included 112 patients (112 eyes) who underwent femtosecond laser-assisted fragmentation of the nucleus with a «cylinders» pattern (division of the nucleus with 8 radial cuts in combination with 5 circular cuts). Group 3 included 121 patients (121 eyes) who underwent femtosecond laser-assisted fragmentation of the nucleus with a «grid» pattern (division of the nucleus with 8 radial cuts in combination with multiple mutually perpendicular cuts in the central zone in the form of a grid with a 0.5 mm cell). Effective ultrasound time and the volume of irrigation solution for emulsification of the lens nucleus fragments were determined during the operation. The loss of corneal endothelial cells was assessed 3 months after surgery.</p><p><strong>Results: </strong>The minimum effective ultrasound time was noted after using the \"grid\" pattern - 4.05 (2.88; 4.74) s, which was significantly less than with the \"cylinders\" pattern - 4.97 (3.78; 5.88) s and the \"pizza\" pattern - 6.15 (4.52; 7.75) s (<i>p</i><0.05). The effective ultrasound time when using the \"cylinders\" pattern was significantly less than with the \"pizza\" pattern (<i>p</i><0.05). The volume of irrigation solution used for emulsification of the lens nucleus fragments was significantly less in the \"grid\" pattern - 41.5 (33.5; 49.5) ml compared to the \"cylinders\" patterns 58.5 (51.0; 66.0), <i>p</i><0.05 and \"pizza\" pattern 75.0 (66.0; 83.5), <i>p</i><0.01. The volume of irrigation solution when using the \"cylinders\" pattern was significantly less than when using the \"pizza\" pattern (<i>p</i><0.05). The loss of corneal endothelial cells after using the \"grid\" pattern was 8.82 (7.59; 9.87)%, which was significantly less than after the \"cylinders\" patterns - 9.97 (8.81; 10.83)%, <i>p</i><0.05 and \"pizza\" - 11.70 (10.62; 12.97)%, <i>p</i><0.05. At the same time, the loss of endothelial cells after using the \"cylinders\" pattern was significantly less than after the \"pizza\" pattern (<i>p</i><0.05).</p><p><strong>Conclusions: </strong>The choice of the optimal pattern of preliminary femtosecond laser-assisted fragmentation of the lens nucleus provides a significant decrease in the energy and hydrodynamic parameters of phacoemulsification and, accordingly, the loss of corneal endothelial cells.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"140 2. Vyp. 2","pages":"129-135"},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Influence of the pattern of femtosecond laser-assisted lens nucleus fragmentation on the energy and hydrodynamic parameters of phacoemulsification].\",\"authors\":\"Yu N Yusef, S N Yusef, A S Vvedenskiy, M N Ivanov, L Alkharki, N D Fokina\",\"doi\":\"10.17116/oftalma2024140022129\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The influence of various patterns of preliminary femtosecond laser-assisted fragmentation of the lens nucleus on the energy and hydrodynamic parameters of phacoemulsification remains insufficiently studied.</p><p><strong>Purpose: </strong>This study evaluates the influence of various patterns of preliminary femtosecond laser-assisted fragmentation of the lens nucleus on the energy, hydrodynamic parameters of phacoemulsification, and the degree of corneal endothelial cell loss.</p><p><strong>Material and methods: </strong>Hybrid phacoemulsification was performed in 336 patients (336 eyes) with grade IV immature cataract according to the Buratto classification in three age-matched groups. Group 1 included 103 patients (103 eyes) who underwent hybrid phacoemulsification with preliminary femtosecond laser-assisted fragmentation of the nucleus with a «pizza» pattern (division of the nucleus with 10 radial cuts). Group 2 included 112 patients (112 eyes) who underwent femtosecond laser-assisted fragmentation of the nucleus with a «cylinders» pattern (division of the nucleus with 8 radial cuts in combination with 5 circular cuts). Group 3 included 121 patients (121 eyes) who underwent femtosecond laser-assisted fragmentation of the nucleus with a «grid» pattern (division of the nucleus with 8 radial cuts in combination with multiple mutually perpendicular cuts in the central zone in the form of a grid with a 0.5 mm cell). Effective ultrasound time and the volume of irrigation solution for emulsification of the lens nucleus fragments were determined during the operation. The loss of corneal endothelial cells was assessed 3 months after surgery.</p><p><strong>Results: </strong>The minimum effective ultrasound time was noted after using the \\\"grid\\\" pattern - 4.05 (2.88; 4.74) s, which was significantly less than with the \\\"cylinders\\\" pattern - 4.97 (3.78; 5.88) s and the \\\"pizza\\\" pattern - 6.15 (4.52; 7.75) s (<i>p</i><0.05). The effective ultrasound time when using the \\\"cylinders\\\" pattern was significantly less than with the \\\"pizza\\\" pattern (<i>p</i><0.05). The volume of irrigation solution used for emulsification of the lens nucleus fragments was significantly less in the \\\"grid\\\" pattern - 41.5 (33.5; 49.5) ml compared to the \\\"cylinders\\\" patterns 58.5 (51.0; 66.0), <i>p</i><0.05 and \\\"pizza\\\" pattern 75.0 (66.0; 83.5), <i>p</i><0.01. The volume of irrigation solution when using the \\\"cylinders\\\" pattern was significantly less than when using the \\\"pizza\\\" pattern (<i>p</i><0.05). The loss of corneal endothelial cells after using the \\\"grid\\\" pattern was 8.82 (7.59; 9.87)%, which was significantly less than after the \\\"cylinders\\\" patterns - 9.97 (8.81; 10.83)%, <i>p</i><0.05 and \\\"pizza\\\" - 11.70 (10.62; 12.97)%, <i>p</i><0.05. At the same time, the loss of endothelial cells after using the \\\"cylinders\\\" pattern was significantly less than after the \\\"pizza\\\" pattern (<i>p</i><0.05).</p><p><strong>Conclusions: </strong>The choice of the optimal pattern of preliminary femtosecond laser-assisted fragmentation of the lens nucleus provides a significant decrease in the energy and hydrodynamic parameters of phacoemulsification and, accordingly, the loss of corneal endothelial cells.</p>\",\"PeriodicalId\":23529,\"journal\":{\"name\":\"Vestnik oftalmologii\",\"volume\":\"140 2. 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[Influence of the pattern of femtosecond laser-assisted lens nucleus fragmentation on the energy and hydrodynamic parameters of phacoemulsification].
The influence of various patterns of preliminary femtosecond laser-assisted fragmentation of the lens nucleus on the energy and hydrodynamic parameters of phacoemulsification remains insufficiently studied.
Purpose: This study evaluates the influence of various patterns of preliminary femtosecond laser-assisted fragmentation of the lens nucleus on the energy, hydrodynamic parameters of phacoemulsification, and the degree of corneal endothelial cell loss.
Material and methods: Hybrid phacoemulsification was performed in 336 patients (336 eyes) with grade IV immature cataract according to the Buratto classification in three age-matched groups. Group 1 included 103 patients (103 eyes) who underwent hybrid phacoemulsification with preliminary femtosecond laser-assisted fragmentation of the nucleus with a «pizza» pattern (division of the nucleus with 10 radial cuts). Group 2 included 112 patients (112 eyes) who underwent femtosecond laser-assisted fragmentation of the nucleus with a «cylinders» pattern (division of the nucleus with 8 radial cuts in combination with 5 circular cuts). Group 3 included 121 patients (121 eyes) who underwent femtosecond laser-assisted fragmentation of the nucleus with a «grid» pattern (division of the nucleus with 8 radial cuts in combination with multiple mutually perpendicular cuts in the central zone in the form of a grid with a 0.5 mm cell). Effective ultrasound time and the volume of irrigation solution for emulsification of the lens nucleus fragments were determined during the operation. The loss of corneal endothelial cells was assessed 3 months after surgery.
Results: The minimum effective ultrasound time was noted after using the "grid" pattern - 4.05 (2.88; 4.74) s, which was significantly less than with the "cylinders" pattern - 4.97 (3.78; 5.88) s and the "pizza" pattern - 6.15 (4.52; 7.75) s (p<0.05). The effective ultrasound time when using the "cylinders" pattern was significantly less than with the "pizza" pattern (p<0.05). The volume of irrigation solution used for emulsification of the lens nucleus fragments was significantly less in the "grid" pattern - 41.5 (33.5; 49.5) ml compared to the "cylinders" patterns 58.5 (51.0; 66.0), p<0.05 and "pizza" pattern 75.0 (66.0; 83.5), p<0.01. The volume of irrigation solution when using the "cylinders" pattern was significantly less than when using the "pizza" pattern (p<0.05). The loss of corneal endothelial cells after using the "grid" pattern was 8.82 (7.59; 9.87)%, which was significantly less than after the "cylinders" patterns - 9.97 (8.81; 10.83)%, p<0.05 and "pizza" - 11.70 (10.62; 12.97)%, p<0.05. At the same time, the loss of endothelial cells after using the "cylinders" pattern was significantly less than after the "pizza" pattern (p<0.05).
Conclusions: The choice of the optimal pattern of preliminary femtosecond laser-assisted fragmentation of the lens nucleus provides a significant decrease in the energy and hydrodynamic parameters of phacoemulsification and, accordingly, the loss of corneal endothelial cells.
期刊介绍:
The journal publishes materials on the diagnosis and treatment of eye diseases, hygiene of vision, prevention of ophthalmic affections, history of Russian ophthalmology, organization of ophthalmological aid to the population, as well as the problems of special equipment. Original scientific articles and surveys on urgent problems of theory and practice of Russian and foreign ophthalmology are published. The journal contains book reviews on ophthalmology, information on the activities of ophthalmologists" scientific societies, chronicle of congresses and conferences.The journal is intended for ophthalmologists and scientific workers dealing with clinical problems of diseases of the eye and physiology of vision.