在生理学压力和高眼内压力下使用活性流体系统进行法化:对前后段生理学的影响
Matthew P Rauen1, Hillery Joiner, Robyn A Kohler
1From the Wolfe Eye Clinic, West Des Moines, Iowa (Rauen, Joiner, Kohler); O'Connor Consulting Services, Charleston, West Virginia (O'Connor).
Journal of cataract and refractive surgery
|April 10, 2024
概括
在白内障手术期间保持低的手术内眼压 (IOP) 可以减少角膜创伤和炎症. 这种方法可以保持内皮细胞密度 (ECD),并尽量减少角膜,而不会影响视觉敏度或视网膜健康.
科学领域:
- 眼科医生 眼科 眼科
- 手术科学 手术科学
- 角膜生理学 角膜生理学
背景情况:
- 发光乳化是一种常见的白内障手术技术.
- 在手术期间的眼内压力 (IOP) 管理对于患者的治疗结果至关重要.
- 高与低IOP对眼睛结构的影响需要进一步研究.
研究的目的:
- 评估在发酵过程中高和低的手术内IOP对眼前和眼后生理学的影响.
- 为了比较低和高IOP组之间的液体消耗,角膜厚度,内皮细胞密度 (ECD) 和手术后炎症.
主要方法:
- 进行了一项前性,随机的双眼临床试验,其中27名参与者接受了双边白内障手术.
- 参与者被随机分配到低 (≤28 mm Hg) 或高 (≥55至60 mm Hg) IOP 在第一眼的发酵和皮质去除过程中,第二眼使用了替代条件.
- 主要结局是液体消耗;次要结局包括中枢角膜厚度,叶无血管区面积,叶和斑点厚度,心电损伤和手术后炎症.
主要成果:
- 低IOP设置显著降低了液体消耗 (40.0毫升相比55.6毫升).
- 低IOP眼睛在1天和1周时显示出较小的角膜厚度变化,1个月和3个月后的ECD下降显着较小 (-1.7% vs -12.3%和2.1% vs -8.9%).
- 视网膜参数和视力敏度在所有时间点在低IOP和高IOP组之间都相似.
结论:
- 在发光乳化过程中低的手术内IOP设置导致角膜创伤和炎症较少.
- 内皮细胞密度 (ECD) 在较低的IOP下更好地保持,而不依赖于液体使用或发酵能量.
- 虽然低IOP可以减少角膜并发症,但它不会显著影响视网膜参数或最终视力敏度.
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