双轴与同轴灌注抽吸在白内障超声乳化皮质吸除中的比较

doi:10.3760/cma.j.issn.1674-845X.2018.04.008

Abstract
Figure/Table
References (14)
Related Citation (15)

Download: PDF (664 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract

Objective: To evaluate the clinical results of cortex removal with biaxial irrigation and aspiration (IA) compared with coaxial IA in phacoemulsification. Methods: This prospective study enrolled cataract patients who underwent phacoemulsification and intraocular lens implantation at the Second People's Hospital of Hefei Affiliated to Anhui Medical University. The patients were divided into two groups (each with 30 patients, 30 eyes) based on the cortex removal mode: biaxial IA and coaxial IA. For the biaxial IA group, we made three corneal incisions: one main incision at 12??00 (phaco tip) and two side port incisions at 3??00 and 9??00 (irrigation and aspiration). For the coaxial IA group, we made one main incision and one side port incision at mutually perpendicular lines. In both groups, normal hydrodissection was set and the nucleus was aspirated with ultrasound phacoemulsification energy. The residual cortex was removed, and posterior capsule polishing was performed using either biaxial IA or coaxial IA. The time (in seconds) required for the removal of the cortex measured from instrument insertion in the eye until aspiration tip removal. Residual cortex, posterior capsule ruptures, visual acuity, and corneal astigmatism were recorded.Data were analyzed by the Mann-Whitney test, chi-square test, and Fisher's exact test. Results: The cortex removal time was 118 ± 10 seconds for the biaxial IA group and 150 ± 16 seconds for the coaxial IA group (Z=-6.174, P<0.001). Compared to coaxial IA, biaxial IA resulted in more stability of the anterior chamber and more effective cortex removal, the success rate of one-off suction in coaxial IA group and biaxial IA group were 57% and 100% respectively. There were no significant differences in visual acuity or corneal astigmatism between the two groups (P>0.05). One posterior capsular tear occurred in the coaxial IA group. Conclusions: Biaxial IA significantly reduced cortex removal time compared to coaxial IA. Biaxial IA appears to be safer and more efficient than coaxial IA in cortex removal.

Key words： irrigation/aspiration cortex biaxial phacoemulsification

Received: 07 November 2017

Corresponding Authors: Yongrong Li, Department of Ophthalmology, the Second People's Hospital of Hefei Affiliated with Anhui Medical University, Hefei 230001, China (Email: Tiger9611@126.com)

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Fengtao Ji
	Yongrong Li
	Wenjuan Sun

Cite this article:

Fengtao Ji,Yongrong Li,Wenjuan Sun. Comparison of Biaxial and Coaxial Irrigation and Aspiration for Lens Cortex Removal in Phacoemulsification[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2018, 20(4): 232-236.

URL:

https://www.cjoovs.com/EN/10.3760/cma.j.issn.1674-845X.2018.04.008 OR https://www.cjoovs.com/EN/Y2018/V20/I4/232

[1]	Martin KR, Burton RL. The phacoemulsification learning curve: per-operative complications in the first 3000 cases of an experienced surgeon. Eye (Lond), 2000, 14 (Pt 2): 190-195.
	DOI: 10.1038/eye.2000.52.
[1]	Martin KR, Burton RL. The phacoemulsification learning curve: per-operative complications in the first 3000 cases of an experienced surgeon. Eye (Lond), 2000, 14 (Pt 2): 190-195.
	DOI: 10.1038/eye.2000.52.
[2]	Thevi T, Sahoo S. Visual outcome following posterior capsule rupture during phacoemulsification in a tertiary care hospital in Malaysia. Med J Malaysia, 2016, 71(2): 45-46.
[3]	章露易, 徐雯, 姚克, 等. 超声乳化白内障吸除术中晶状体后囊膜破裂风险因素分析. 中华眼科杂志, 2015, 51(4): 282-287.DOI: 10.3760/cma.j.issn.0412-4081.2015.04.010.
[4]	Ti SE, Yang YN, Lang SS, et al. A 5-year audit of cataract surgery outcomes after posterior capsule rupture and risk factors affecting visual acuity. Am J Ophthalmol, 2014, 157(1): 180-185. DOI:10.1016/j.ajo.2013.08.022.
[2]	Thevi T, Sahoo S. Visual outcome following posterior capsule rupture during phacoemulsification in a tertiary care hospital in Malaysia. Med J Malaysia, 2016, 71(2): 45-46.
[3]	章露易, 徐雯, 姚克, 等. 超声乳化白内障吸除术中晶状体后囊膜破裂风险因素分析. 中华眼科杂志, 2015, 51(4): 282-287.DOI: 10.3760/cma.j.issn.0412-4081.2015.04.010.
[4]	Ti SE, Yang YN, Lang SS, et al. A 5-year audit of cataract surgery outcomes after posterior capsule rupture and risk factors affecting visual acuity. Am J Ophthalmol, 2014, 157(1): 180-185. DOI:10.1016/j.ajo.2013.08.022.
[5]	Pingree MF, Crandall AS, Olson RJ. Cataract surgery complications in 1 year at an academic institution. J Cataract Refract Surg, 1999, 25(5): 705-708.
[5]	Pingree MF, Crandall AS, Olson RJ. Cataract surgery complications in 1 year at an academic institution. J Cataract Refract Surg, 1999, 25(5): 705-708.
[6]	Chylack LT Jr, Wolfe JK, Singer DM, et al. The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol, 1993, 111(6): 831-836.
[7]	李博, 张素华, 张哲, 等. 2.2 mm透明角膜切口飞秒激光辅助白内障超声乳化手术术源性散光的临床研究. 中华眼视光学与视觉科学杂志, 2016, 18(11): 654-659. DOI: 10.3760/cma.
[6]	Chylack LT Jr, Wolfe JK, Singer DM, et al. The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol, 1993, 111(6): 831-836.
[7]	李博, 张素华, 张哲, 等. 2.2 mm透明角膜切口飞秒激光辅助白内障超声乳化手术术源性散光的临床研究. 中华眼视光学与视觉科学杂志, 2016, 18(11): 654-659. DOI: 10.3760/cma.
	j.issn.1674-845X.2016.11.004.
[8]	Izquierdo L Jr, Henriquez MA, McCarthy M. Double aspiration/single irrigation system for bimanual lens cortex removal in cataract surgery. Ophthalmic Surg Lasers Imaging, 2011, 42(1):81-82. DOI: 10.3928/15428877-20101124-02.
	j.issn.1674-845X.2016.11.004.
[8]	Izquierdo L Jr, Henriquez MA, McCarthy M. Double aspiration/single irrigation system for bimanual lens cortex removal in cataract surgery. Ophthalmic Surg Lasers Imaging, 2011, 42(1):81-82. DOI: 10.3928/15428877-20101124-02.
[9]	Brauweiler P. Bimanual irrigation/aspiration. J Cataract Refract Surg, 1996, 22(8): 1013-1016.
[9]	Brauweiler P. Bimanual irrigation/aspiration. J Cataract Refract Surg, 1996, 22(8): 1013-1016.
[10]	Hagan JC 3rd. A new cannula for removal of 12 o'clock cortex through a sideport corneal incision. Ophthalmic Surg, 1992,23(1): 62-63.
[10]	Hagan JC 3rd. A new cannula for removal of 12 o'clock cortex through a sideport corneal incision. Ophthalmic Surg, 1992,23(1): 62-63.
[11]	Shimada Y, Horiguchi M, Kojima Y, et al. Transparent irrigation cannula for bimanual lens cortex removal. J Cataract Refract Surg, 2002, 28(2): 221-223.
[12]	Conrad-Hengerer I, Schultz T, Jones JJ, et al. Cortex removal after laser cataract surgery and standard phacoemulsification: a critical analysis of 800 consecutive cases. J Refract Surg, 2014,30(8): 516-520. DOI: 10.3928/1081597X-20140624-01.
[13]	Dick HB. Controlled clinical trial comparing biaxial microincision with coaxial small incision for cataract surgery.Eur J Ophthalmol, 2012, 22(5): 739-750. DOI: 10.5301/
[11]	Shimada Y, Horiguchi M, Kojima Y, et al. Transparent irrigation cannula for bimanual lens cortex removal. J Cataract Refract Surg, 2002, 28(2): 221-223.
[12]	Conrad-Hengerer I, Schultz T, Jones JJ, et al. Cortex removal after laser cataract surgery and standard phacoemulsification: a critical analysis of 800 consecutive cases. J Refract Surg, 2014,30(8): 516-520. DOI: 10.3928/1081597X-20140624-01.
[13]	Dick HB. Controlled clinical trial comparing biaxial microincision with coaxial small incision for cataract surgery.Eur J Ophthalmol, 2012, 22(5): 739-750. DOI: 10.5301/
	ejo.5000100
[14]	Kurz S, Krummenauer F, Thieme H, et al. Biaxial microincision versus coaxial small-incision cataract surgery in complicated cases. J Cataract Refract Surg, 2010, 36(1): 66-72. DOI: 10.1016/j.jcrs.2009.07.036.
	ejo.5000100
[14]	Kurz S, Krummenauer F, Thieme H, et al. Biaxial microincision versus coaxial small-incision cataract surgery in complicated cases. J Cataract Refract Surg, 2010, 36(1): 66-72. DOI: 10.1016/j.jcrs.2009.07.036.