[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]。

Q3 Medicine Vestnik oftalmologii Pub Date : 2024-01-01 DOI:10.17116/oftalma2024140022129
Yu N Yusef, S N Yusef, A S Vvedenskiy, M N Ivanov, L Alkharki, N D Fokina
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引用次数: 0

摘要

飞秒激光辅助碎裂晶状体核的不同模式对超声乳化的能量和流体力学参数的影响仍未得到充分研究。目的:本研究评估了不同模式的飞秒激光辅助晶状体核碎裂对超声乳化能量、流体力学参数以及角膜内皮细胞损失程度的影响。材料与方法:根据Buratto分类法,对336例IV级未成熟白内障患者(336只眼)进行了混合超声乳化,分为三个年龄匹配组。第一组包括 103 名患者(103 只眼),他们接受了混合乳化术,并在飞秒激光辅助下以 "披萨 "模式(用 10 个径向切口分割晶体核)初步碎核。第 2 组包括 112 名患者(112 只眼),他们接受了飞秒激光辅助的 "圆柱 "模式碎核(用 8 个径向切口结合 5 个环形切口分割晶体核)。第3组包括121名患者(121只眼),他们接受了飞秒激光辅助的 "网格 "模式碎核(用8个径向切口结合中心区多个相互垂直的切口以0.5毫米单元网格的形式分割细胞核)。手术过程中确定了有效的超声时间和乳化晶状体核碎片的灌洗液量。术后 3 个月评估角膜内皮细胞的损失情况:结果:使用 "网格 "模式后,有效超声时间最短为 4.05 (2.88; 4.74) 秒,明显少于使用 "圆柱 "模式的 4.97 (3.78; 5.88) 秒和使用 "披萨 "模式的 6.15 (4.52; 7.75) 秒:选择飞秒激光辅助初步碎裂晶状体核的最佳模式可显著降低超声乳化的能量和流体力学参数,从而减少角膜内皮细胞的损失。
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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.

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来源期刊
Vestnik oftalmologii
Vestnik oftalmologii Medicine-Ophthalmology
CiteScore
0.80
自引率
0.00%
发文量
129
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.
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