| 刘广源,刘家佳,温跃春.重力液流与主控液流对白内障超声乳化术术后视力恢复及视觉质量的影响[J].安徽医药,2020,24(6):1134-1137. |
| 重力液流与主控液流对白内障超声乳化术术后视力恢复及视觉质量的影响 |
| Effect of gravity fluidic system and active control fluidic system on visual acuity recovery and visual quality after phacoemulsification of cataract |
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| DOI：10.3969/j.issn.1009?6469.2020.06.018 |
| 中文关键词: 超声乳化白内障吸除术/方法 内皮，角膜 角膜波前像差 视觉，眼 主动控制液流系统 |
| 英文关键词: Phacoemulsification/methods Endothelium,corneal Corneal wavefront aberration Vision,ocular Active fluidic |
| 基金项目:安徽省公益性研究联动计划( 1604f0804008) |
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| 中文摘要: |
| 目的比较重力液流与主控液流两种灌注方式下白内障超声乳化手术病人视力恢复及视觉质量的影响。方法选取 2018年 6月至 2019年 6月于安徽医科大学附属省立医院眼科因年龄相关性白内障行白内障超声乳化吸除联合人工晶体植入术的手术病人 40例 40眼。采用随机数字表法将病人分为试验组、对照组。试验组 20例 20眼术中采用主控液流系统(主控灌注)进行白内障超声乳化手术，对照组 20例 20眼采用重力液流系统(重力灌注)白内障超声乳化手术。分别记录术中超声能量的使用情况( CDE)术后 1d、1周、 1月病人最佳矫正视力( BCVA)、角膜内皮情况［角膜内皮细胞密度( ECD)、中央角膜厚度(CCT)］，使用 iTrace分，别测量术眼自然状态下瞳孔直径 3 mm时的高阶像差及高阶像差下的调制传递函数( MTF)数据分析采用单因素方差分析。结果术前两组在一般资料比较，差异无统计学意义。两组术中的 CDE比较试验组( 5.54±0.91，)s小于对照组( 7.27±1.47)s(P＜0.001)。两组 BCVA在术后 1d、1周、 1月差异有统计学意义( P＜0.05)。两组 ECD在术前、术后 1d、 1周、 1月均差异无统计学意义( P＞0.05)。试验组在术后 1d、1周 CCT均小于对照组，试验组在术后 1d、1周、 1月的全眼(瞳孔直径 3 mm)高阶像差及高阶像差下的 MTF优于对照组，且均差异有统计学意义( P＜0.05)。而两组的总高阶像差随着时间推移逐渐接近同一水平。结论主控灌注相较于传统的重力灌注在白内障超声乳化手术中能够减少超声能量的使用，减少角膜内皮损伤，进而减轻术后角膜水肿和高阶像差的改变，使病人获得更好的术后视力及视觉质量。 |
| 英文摘要: |
| Objective To compare the effects of gravity fluidic and active fluidic on visual acuity recovery and visual quality in pa?tients undergoing phacoemulsification.Methods Totally 40 eyes of 40 patients were selected，who underwent cataract phacoemulsi?fication combined with intraocular lens implantation for age?related cataract in the Department of Ophthalmology，Anhui Medical University Affiliated Provincial Hospital from June 2018 to June 2019.Random number table method was used to randomly assignthe patients into study group and control group.In the study group，20 cases(20 eyes)were treated with phacoemulsification using the active fluidic system，and 20 cases(20 eyes)in the control group were treated with phacoemulsification using gravity fluidicsystem.Records were kept of the intraoperative color Doppler energy(CDE)，the patient’s best corrected visual acuity(BCVA)， corneal endothelial condition［corneal endothelial cell density(ECD)， central corneal thickness(CCT)］ at 1 d，1 week，and 1 month after surgery.ITrace was used to measure the higher?order aberrations and the modulation transfer function(MTF)under higher?order aberrations when the pupil diameter was 3 mm in the natural state of the surgical eye，and the data analysis was made by one?way ANOVA.Results There was no statistically significant difference between the two groups in general data before sur?gery.The intraoperative CDE in the study group was smaller than that in the control group［( 5.54±0.91)s vs.(7.27±1.47)s；P＜ 0.001］.The difference in BCVA between the two groups was statistically significant at 1 day，1 week，and 1 month after surgery(P＜0.05).There was no significant difference in ECD between the two groups before surgery，1 day，1 week，and 1 month after sur? gery(P＞0.05).The CCT of the study group was smaller than that of the control group at 1 day and 1 week after surgery.The total eye(pupillary diameter 3 mm)higher?order aberrations and MTF under higher?order aberrations in the study group were better than those in the control group at 1 day，1 week and 1 month after surgery，and the differences were statistically significant(P＜0.05).The total higher?order aberrations of the two groups gradually approached the same level over time.Conclusion Comparedwith the traditional gravity fluidic system，the active fluidic system can reduce the use of color Doppler energy and reduce cornealendothelial injury during cataract phacoemulsification surgery，thereby reducing postoperative corneal edema and higher?order aber? ration changes，so that patients can get better postoperative vision and visual quality. |
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