CAJ | 학술논문

在白内障超声乳化中采用一种新型劈核方法-分核器机械劈核代替常规超声劈核，以此降低术中超声能量使用、缩短超声时间和减少灌注液的使用，从而达到保护角膜内皮细胞和降低手术并发症的目的。方法采用分核器机械劈核（实验组）与常规超声劈核（对照组）进行对比。各组选择病例100例（Ⅱ级核50例，Ⅲ级核50例），记录手术中使用超声能量和超声时间进行比较，观察术后第2天角膜内皮细胞和角膜基质细胞形态改变。结果实验组和对照组比较：（1）实验组超声时间平均每例降低9．04 s，有显著差异（ P ＝0．009）；（2）实验组超声能量平均每例降低1．74，有显著差异（ P ＝0．001）；（3）实验组术后第2天角膜内皮细胞和基质细胞形态改变明显好于对照组。结论使用分核器机械劈核代替目前的超声劈核技术，操作更简单，可以明显减少超声对角膜内皮细胞的损伤，降低手术并发症，达到白内障超声乳化手术微创目的。
재백내장초성유화중채용일충신형벽핵방법-분핵기궤계벽핵대체상규초성벽핵，이차강저술중초성능량사용、축단초성시간화감소관주액적사용，종이체도보호각막내피세포화강저수술병발증적목적。방법채용분핵기궤계벽핵（실험조）여상규초성벽핵（대조조）진행대비。각조선택병례100례（Ⅱ급핵50례，Ⅲ급핵50례），기록수술중사용초성능량화초성시간진행비교，관찰술후제2천각막내피세포화각막기질세포형태개변。결과실험조화대조조비교：（1）실험조초성시간평균매례강저9．04 s，유현저차이（ P ＝0．009）；（2）실험조초성능량평균매례강저1．74，유현저차이（ P ＝0．001）；（3）실험조술후제2천각막내피세포화기질세포형태개변명현호우대조조。결론사용분핵기궤계벽핵대체목전적초성벽핵기술，조작경간단，가이명현감소초성대각막내피세포적손상，강저수술병발증，체도백내장초성유화수술미창목적。
Objective In order to minimize the ultrasonic energy and duration in phacoemulsification , to protect corneal endothelium , and to reduce complications of cataract surgeries , we compared mechanical chopping with phaco chopping of the nuclear in cataract surgeries .Methods Our patients were divided into two groups to receive either me-chanical nuclear chopping (group I, n=100) or ultrasonic chopping (group II, n=100) in cataract phacoemulsification. We compared energy and duration needed during surgery and postoperative endothelium morphology between the two groups.Results Both energy and time that are needed in the surgery was significantly less in patients who received me -chanical nuclear chopping .Postoperative endothelium morphology was also better in patients who received mechanical nu -clear chopping .Conclusion Mechanical nuclear chopping is a safer alternative for phaco chopping in cataract surgery .It is easier to perform , and has less adverse effects on corneal endothelium .