CAJ | 학술논문

目的：比较预劈核联合乳化劈核与拦截劈核两种劈核方式，探讨预劈核联合乳化劈核的技术优点。 　　方法：将年龄相关性白内障131例156眼随机分为预劈核联合乳化劈核组（ A组）68例82眼和拦截劈核组（ B组）63例74眼。分别使用预劈核联合乳化劈核和拦截劈核技术进行白内障超声乳化术。记录术中平均超声能量（AP）、实际超声乳化时间（U/S time）、累积能量复合参数（ AECP ）、平均内皮细胞密度、平均内皮细胞丢失率、术中并发症、术后1d；1wk裸眼视力和术后1d角膜水肿等情况并进行比较。 　　结果：将两组中同级核硬度的亚组进行比较，A组的AP，U/S time，AECP均低于B组，差异有显著性；且前者术后第1d角膜水肿轻于后者。术后1d裸眼视力A组优于B组，术后1 wk两组裸眼视力无差异。两组术后3 mo平均角膜内皮细胞密度无差异（P＞0．05），但两组术后3mo平均角膜内皮细胞丢失率差异有显著性（P＜0．05）。术中出现晶状体后囊膜破裂A组有2眼（2．4％），B组有4眼（5．4％）。 　　结论：与拦截劈核相比，预劈核联合乳化劈核术中超声时间更短、能量更低、术后3 mo角膜内皮细胞丢失率更少、术后早期裸眼视力更好。
목적：비교예벽핵연합유화벽핵여란절벽핵량충벽핵방식，탐토예벽핵연합유화벽핵적기술우점。 　　방법：장년령상관성백내장131례156안수궤분위예벽핵연합유화벽핵조（ A조）68례82안화란절벽핵조（ B조）63례74안。분별사용예벽핵연합유화벽핵화란절벽핵기술진행백내장초성유화술。기록술중평균초성능량（AP）、실제초성유화시간（U/S time）、루적능량복합삼수（ AECP ）、평균내피세포밀도、평균내피세포주실솔、술중병발증、술후1d；1wk라안시력화술후1d각막수종등정황병진행비교。 　　결과：장량조중동급핵경도적아조진행비교，A조적AP，U/S time，AECP균저우B조，차이유현저성；차전자술후제1d각막수종경우후자。술후1d라안시력A조우우B조，술후1 wk량조라안시력무차이。량조술후3 mo평균각막내피세포밀도무차이（P＞0．05），단량조술후3mo평균각막내피세포주실솔차이유현저성（P＜0．05）。술중출현정상체후낭막파렬A조유2안（2．4％），B조유4안（5．4％）。 　　결론：여란절벽핵상비，예벽핵연합유화벽핵술중초성시간경단、능량경저、술후3 mo각막내피세포주실솔경소、술후조기라안시력경호。
AIM:To compare two phaco techniques, namely phaco prechop with phaco chop and divide and conquer, and to discuss the technical advantages of phaco prechop with phaco chop METHODS:The study included 131 patients ( 156 eyes ) with age-related cataract eyes divided into 2 groups, group A including 68 patients (82 eyes), in which phaco prechop with phaco chop was performed, and group B including 63 patients ( 74 eyes ) , in which divide and conquer was performed.The mean parameters including average power ( AP ) , U/S time, accumulated energy complex parameter ( AECP) , mean endothelial cell count, mean endothelial cell loss, intraoperative complications, postoperative uncorrected visual acuity (UCVA) at 1d and 1wk, and corneal edema were reported in the two groups both preoperative and postoperative. RESULTS:The subgroups with same grade of lens nucleus hardness were compared. Parameters such as AP, U/S time, AECP in group A were significantly less than those in group B.Postoperative corneal clarity and UCVA at 1d in group A was better than that in group B. No significant difference was found in UCVA at 1wk after operation between the two groups. The difference in mean endothelial cell count at 3mo postoperative between the two groups was statistically insignificant (P>0.05), however the difference in endothelial cell loss at 3mo postoperatively between the two groups was statistically significant (P<0.05).Two cases in groups A (2.4%) had posterior capsular rents compared to four cases (5.4%) in group B. CONCLUSION: Compare with divide and conquer, phaco prechop with phaco chop utilized less phaco time, energy, and the rate of endothelial cell loss at 3mo postoperatively, and better early postoperative uncorrected visual acuity.