The Observation Of The Clinical Treatment Effect Of Phacoemulsification Of Torsional Mode

Preface:Phacoemulsification is the main treatment to cure cataract.Because the operation can produce heat which can injure the intraocular tissues,the probable method to reduce the ultrasound energy and the heat injury is of great importance to improve the phaco system. As the modern medical technique having been developed into the period of micro-incision surgery,the micro-incision cataract surgery(MICS) come to prevail.And consequently, many new techniques are deeply developed.Laser emulsification,sound wave emulsification and liqualase find different ways to reduce the energy.Whitestar technique is a shining model of emusification.It eliminates the heat enery in theory.NeoSoniX is a special emusification system develped by Alcon company,which can provide both linear ultrasound vibration and sound wave vibration.Though torsional mode of the infiniti system is similar to the NeoSonix system,it only provide ultrasoundvibration,and the horizontal vibration frequency is far more than that of NeoSonix.In theory, the torsional mode have the advantage in technique. By far the corresponding report of the clinical treatment result is in great need.This study is to observe the clinical treatment effect of the torsional mode which severs as a reference to the surgeons.Objective:To evaluate the clinical treatment effect of the torsional mode of phacoemusification.Methods:In this randomized study,161 patients(180 eyes) were assigned to phacoemulsification.Acording to the nucleus density,they were divided into soft neucleus group(group A,nucleus density, gradeâ… -â…¡,101 eyes) and hard neucleus group(group B,nucleus density ,gradeâ…¢-â…£,79 eyes). And each group were divided into 3 sub-group in random,which were given the treatment of phacoemulsification of US mode,torsional mode only and torsional mode with linear conventional ultrasound respectively.Primary outcome measures were UST.Thepatients were seen 1 day and 1 week after the surgery.Postoperative outcome measures were the final best corrected visual acuity and the change in corneal clarity,central corneal endothelial cell count.Results:US time:In group A ,there is no difference in statistics between 3 sub-group(p>0.05).and in group B ,B3 sub-group is shortest(p<0.05);Cornea edema:in group A A2 sub-group is most slight;in group B ,B3 sub-group is most slight(p<0.05),and B2 is most serious(p<0.05).The BCVA after the surgery have no difference(p>0.05). Endothelial cell loss after 1 week: in group A ,A2 is lest (p<0.05),and in group B ,B3 is lest(p<0.05),on the contrary,B2 is most (p<0.05).Discussion:By far the inovation of the phacoemulsification system is focusing on the modulation of the ultrasound energy,to have fully use of the ultrasound,and to reduce the energy.And the skilled surgery can take the place of the enery ,thus reduce the complications relating to the energy.Nowadays, thephacoemulsification skills are all relating to the chopping of nucleus.And all groups assigned to the reserch use this skill.In this research ,the loss of endothelial cell has the differences.Because all groups took the same surgery,use the same material,and are conducted by the same surgeon,the difference is most likely due to different energy. in application,torsional mode with a little linear ultrasound can make phacoemulsification more easier,and can reduce UST and surgery time in great extent.In this research,the clinial treatment effect of torsional mode with linear ultrasound surpass the others when dealing with hard nuclei,and although is inferior to torsional mode when dealing with soft nuclei,its clinical effect in general is still satisfying.Conclusion:In phacoemulsification,to get a better clinial treatment,torsional mode only is used to deal with the soft nucleus,and the torsional mode with linear ultrasound to deal with the hard nucleus.The choice of theproper mode according to the density of the nucleus is of great importance.The phacoemulsification system with torsional mode is better than the conventional one when proper energy mode is selected,and it will be widely used in future.