Note suction handle phacoemulsification small incision cataract phacoemulsification surgery

 

(Yining City, Xinjiang agricultural division Hospital, Yining, Xinjiang 835000; 2 People's Hospital of Jiangsu University Affiliated Zhenjiang, Jiangsu 212000)

 

    Abstract: Objective phaco Note suction handle inward impaired in non-small cut u phacoemulsification application results. Methods 391 cases of 400 divided into two groups: A group of traditional suction needle injection group (200), B group of super-absorbing handle milk injection group (200), are used manual small cut [_] extracapsular cataract extraction combined posterior chamber intraocular lens implantation. Two groups of operative time, postoperative visual acuity and complications were compared. Results Group B operative time, postoperative 1 d vision, posterior capsular breakage ld incidence and postoperative corneal edema rates were (12.00 ± 1.03) min, (0.29 ± 0.01), 2.5% and 10.0% respectively; while A group, respectively (15. 00 ± 0.79) min, (0. 20 ± 0.03), 7.5% and 18.5%, the difference was statistically significant (P <0.05). Postoperative long-term vision, intraoperative hyphema, intraocular lens (IOL) implantation, and not after the first 3 + ld aqueous cells occurs above the difference was not statistically significant. Conclusion Super Milk Note suction applied to the handle inward barrier small cut non-phacoemulsification u can improve the efficiency of irrigation-aspiration cortex, safe, effective and worthy of promotion.

 

    Keywords: cataract; small cut U; phaco Note suction handle

 

    CLC: R776.1 Document code: A Article ID :1009 -5551 (2012) 06-0831-03

 

    Cataract is an eye blindness is one of the poor western regions the focus of prevention of blindness '1]. Cataract surgery is the only way, the current commonly used method is phacoemulsification and small incision phacoemulsification extracapsular cataract extraction surgery. Phacoemulsification with tissue injury, wound healing, postoperative astigmatism and faster visual recovery while reducing the stability and other advantages. 2J. But they use expensive equipment, patients prone to complications, the popularization of the primary hospital have more difficulties. The small incision phacoemulsification equipment requirements low, easy to master, but also for the treatment of hard nucleus cataract has a unique advantage. However, in the conventional surgical procedure Note suck suck the injection needle with cortical perfusion when a small amount of negative pressure and small defects, anterior chamber prone to instability, posterior capsular damage and postoperative complications such as corneal edema. To further explore the phaco Note suction handle small incision cataract phacoemulsification in the application results of this study is to switch the injection suction cortex phacoemulsification handle, and with the use of traditional needle injection compared the effect of suction, are reported below.

 

1 Materials and Methods

 

1.1 General information on 391 cases of 400 patients, including 351 age-related cataract, diabetic cataract 39, complicated cataract 10. Patients aged 38 to 92 years, mean (64. 74 ± 2. 15) years of age. 200 cases of male and 1 female 91 cases. Preoperative visual acuity of light perception to 0.3. Divided into two groups: A group of traditional suction needle injection group, 200; B group phaco Note suction handle group, 200. Were confirmed by outpatient vision, ophthalmology and ocular slit lamp examination to exclude non-Shu blinding cataract patients. Diagnosed as cataracts, blood in all patients, ECG, chest X-ray, blood clotting function, intraocular pressure measurement, and lacrimal other preoperative examination.

 

1.2 Methods

 

1.2.1 preoperative preparation Note suction needle 66 Vision Medical Devices in Suzhou manufacturing plant common on the 8th Note suction lumen needles; super suction handle milk Note Note by the Allergan compact suction handle refitted: out of the casing are made of original the distribution of the silicone infusion tube, outlet connection 30 mL syringe. All operations were performed by an experienced physician with a finish. Patients underwent hospital eye AB ultrasound, to understand the eye, to determine intraocular lens power, and improve preoperative preparation. All pending surgical patients were on preoperative 3d eyes drops 0.3% levofloxacin eye drops four times daily. 1.2.2 preoperative surgical 1 h with compound tropicamide eye drops fully dilated, 2% lidocaine 2.5 ~ 3 mL retrobulbar anesthesia. 12:00 bit to do with the basement of the conjunctival fornix flap, coagulation, limbus, 2 mm do anti-eyebrow-shaped scleral tunnel incision, chord length 5.5 ~ 6 mm, depth 1/2 scleral thickness and separation to the limbus 1.5 mm from. Incision in the left eye or right eye position 3:00 9:00 bits limbus incision forward by the injection of viscoelastic room after puncture and expand incision, incision length is greater than the outer incision was inverted trapezoid. Capsulotomy needle or tweezers continuous curvilinear capsulorhexis sac, sac hole diameter 6 mm or more. Sufficient water separation after nuclear transfer out to the front room pouch. Before and after the injection of an appropriate amount of crystal nucleus viscoelastic to protect the corners Bin endothelium, circle pad is set in Nucleation, nuclear devices will use split to two nuclear split, such as nuclear bigger then split into three were caught out. A group of traditional suction needle injection, B group with a super suction handle Note Note suck milk cortex, Note suction is completed, the anterior chamber injection of viscoelastic, implant diameter 5.5 mm PMMA hard pieces of Alcon IOL (IOL) in the capsular bag, and then suck out the injection suction method viscoelastic. Note suck when the cortex, A group operation consists of surgery done alone, B group phaco surgery right hand Note suction handle, left-handed grip tweezers microscopic incision is closed as far as possible so as to reduce the leakage of liquid, with the aid of 30 mL of assisted surgery for injection syringe suction. Water before the end of surgery to deepen the anterior chamber and check for any leaks incision, giving individual incision suture needle, cut the rest of autistic without suture. Surgery eye surgery Tu TobraDex ointment, monocular dressing. After topical application tobradex eye drops four times a day. 1.3 OUTCOME MEASURES (1) operation time; (2) visual acuity (after the first ld, after 1 w, after 1 month and 3 months after surgery); (3) hyphema, posterior capsular damage, intraocular lens (IOL) implantation is not, postoperative corneal edema and anterior chamber reaction ld complications such situations. 1.4 Statistical analysis using SPSS13.O software testing and experimental data f) c2 test, test level d-0. 05.

 

2 Results

 

2.1 Comparison of two operative time in group A mean operative time was (15. 00 ± 0.79) min, B group, mean operative time was (12. 00 ± 1. 03) min, the difference was statistically significant (P < 0.05); 2.2 Comparison of postoperative visual acuity were measured postoperative ld, lw, 1 month, 3 months, visual acuity, B group patients after 1 d obviously superior visual acuity in group A, difference was statistically significant (P <0.05), Table 1.

 

2.3 Comparison of two surgical complications in group B posterior capsular breakage and 1 d after the first occurrence of corneal edema was significantly lower in group A, the difference was statistically significant (P <0.05); groups in the anterior chamber hemorrhage, IOL is not 1 d after the first implant and aqueous cells + + + is no statistically significant difference in the incidence. All patients had surgical incision leakage, nuclear block off into the vitreous cavity, fulminant choroidal hemorrhage, corneal decompensation, endophthalmitis and IOL gripping occurrence in Table 2.

 

3 Discussion

 

    In recent years, phacoemulsification technology in China has been rapid development, and achieved good surgical results, but because of surgical equipment is expensive so the popularity of this technology has been obvious limitations' Hu. While the small incision phacoemulsification extracapsular surgery combined phacoemulsification characteristics, the scleral tunnel incision, continuous curvilinear capsulorhexis and chop technology, with shorter operative time, corneal astigmatism, postoperative visual acuity quick recovery. Due to the small incision phacoemulsification technique simple equipment, and thus in economically underdeveloped central and western regions The procedure can be used as phacoemulsification good and necessary supplement.

 

    However, in actual operation found that the traditional needle with a perfusion lumen Note suck a small amount of negative pressure defects such as small and easy to operate, easy to occur during surgery the following questions: (1) when the suction from the main incision anterior instability Note ; (2) auxiliary incision Note suck when tightness is good, but difficult to operate; (3) the formation of negative pressure is too small, such as the case when a large block of cortical slow injection suction, suction is completed Note inertia easy due to negative broken or damaged suction posterior cornea; (4) due to the traditional dual-chamber injection needles poorly designed suction, suction grip handle as phaco Note arrows fitness, affecting Note suction efficiency. Note suck compared two kinds of tools, not difficult to find, since the conventional dual-chamber injection suction lumen were thin needle is not easy to have a greater perfusion and negative, seriously affecting Note suction efficiency. Meanwhile, as part of the hospital surgical instruments for extracapsular phacoemulsification equipment maintenance is far less elaborate, intraluminal residual cortex, further reducing the traditional needle injection suction efficiency. Thus prompting the phacoemulsification surgical instruments in Note suction handle design advantages for small incision phacoemulsification.

 

    Note improved suction handle in small incision phacoemulsification played a note suction efficiency, safety features Note suck 's]. This study shows that using injection suction handle group B in the intraoperative complications, and postoperative recovery of vision on the different degree than in group A, and the difference was statistically significant. In the course of us to appreciate the super milk Note suction handle has the following advantages: (1) Note suck wife perfusion cannula handle and easy connection, easy to use, from the traditional dual-chamber injection needle converted to injection suction suction handle virtually no learning curve; (2) Use Pumping the handle from the main incision into the left hand grip with toothed forceps main incision 1/2, can effectively form a closed anterior chamber, the operation is very simple.

 

    In summary, note suction handle in small incision phacoemulsification application has good prospects, because of its small investment, Note suction efficiency significantly, it is worth the small incision phacoemulsification promote the use.