【摘要】 目的:探讨无能量劈核技术在白内障超声乳化联合三焦点人工晶体植入术中的应用。方法:选取23例白内障超声乳化联合三焦点人工晶体植入术患者的30眼作为研究对象,根据手术中使用乳化方法不同分为观察组和对照组,每组各15眼。观察组采用无能量劈核法,对照组采用传统超声乳化劈核法。比较两组术中有效超声乳化时间;术前、术后1 d、术后1周及术后1个月角膜内皮细胞密度(ECD)、角膜中央厚度(CCT)及术后1个月角膜内皮细胞丢失率;术后1 d远、中、近视力(包括裸眼和矫正)及离焦曲线范围。结果:观察组术中有效超声乳化时间短于超乳劈核组(P<0.05)。术前,两组ECD比较,差异无统计学意义(P>0.05);两组ECD在术后1 d、术后1周、术后1个月,逐渐逐渐降低,且观察组高于对照组(P<0.05)。观察组术后1个月角膜内皮细胞丢失率小于对照组(P<0.05)。术后1 d,两组CCT比较,差异有统计学意义(P<0.05);术前、术后1周和术后1个月两组CCT比较,差异无统计学意义(P>0.05)。术后1 d两组均获得较好的视力,但观察组远、中、近视力(包括裸眼和矫正)优于对照组(P<0.05)。观察组离焦曲线+2D～-4D范围位于对照组之下(P<0.05)。结论:在施行白内障超声乳化联合三焦点人工晶体植入术时,使用无能量劈核技术能更好保护角膜内皮,减轻角膜水肿,术后短期的视力优于超声乳化劈核技术,值得临床推广。更多还原

【Abstract】 Objective: To investigate the application of power-free chop in phacoemulsification combined with trifocal intraocular lens implantation.Methods:23 patients(30 eyes) who underwent phacoemulsification combined with trifocal intraocular lens implantation were included in the study.The patients were divided into two groups according to the different emulsification methods, 15 eyes in each groups.The observation group underwent power-free chop, and the control group underwent phaco chop.The effective phacoemulsification time during the operation was recorded.We also observed corneal endothelial cell density(ECD) and CCT before operation, 1 day, 1 week and 1 month after operation.The loss rate of corneal endothelial cells in the 1 months after operation was calculated.1 day after operation, the distance, middle and near vision(naked and corrected) of the two groups were measured and compared, and the defocus curve was drawn and compared.Results:The effective phacoemulsification time in the observation group was less than that in the control group(P<0.05).Before operation, there was no significant difference in ECD between the two groups(P>0.05),the ECD of the two groups decreased gradually 1 d, 1 w and 1 m after operation(P<0.05),and the ECD of the observation group was higher than that of the control group(P<0.05).The loss rate of corneal endothelial cells in the observation group was lower than that in the control group at 1 month after surgery(P<0.05).There was a statistically significant difference in CCT between the two groups at 1 day after operation(P<0.05).There was no significant difference in CCT between the two groups before operation, 1 week after operation and 1 month after operation(P>0.05).On the first day after operation, both groups had better visual acuity, but the distance, middle, and near vision(including the naked eye and correction) in the observation group were better than those of the control group(P<0.05).The range of defocus curve +2 D～-4 D in the observation group was lower than that in the control group(P<0.05).Conclusion: When performing phacoemulsification combined with trifocal intraocular lens implantation, power-free chop technique takes less damage to the corneal endothelium and can reduces corneal edema.The short-term postoperative vision is better than that in phaco chop technique.This technique is worthwhile Clinical application.更多还原