超声乳化白内障摘除术中角膜热损伤的研究现状  

Corneal thermal injury during phacoemulsification aspiration

作　　者：曹宇 吴坚[1] 陈威 顾珊珊[1] 薛莹[1] 管怀进[1] Cao Yu;Wu Jian;Chen Wei;Gu Shanshan;Xue Ying;Guan Huaijin(Department of Ophthalmology,the Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu Province,China)

机构地区：[1]南通大学附属医院眼科,江苏省南通市226001

出　　处：《国际眼科纵览》2020年第1期38-41,共4页International Review of Ophthalmology

基　　金：江苏省科技计划项目基金(BE2016699)。

摘　　要：超声乳化白内障摘除术中超乳能量的使用会产生热能,可能导致角膜的热损伤。对角膜切口的热损伤可能导致切口闭合困难,从而导致切口渗漏,邻近角膜基质和内皮的损伤。此外,超乳尖端周围的热量不仅会引起角膜切口损伤,也会引起前房温度升高及角膜内皮损伤。不同超乳持续时间、超乳模式、超乳能量以及不同超乳仪对前房温度均有一定影响,医生应尽量在脉冲模式下选用较低超声能量进行手术,同时应减少超乳持续时间。此外,黏弹剂及其类型以及灌注液持续灌注均是超乳过程中前房温度变化的重要影响因素。Phacoemulsification aspiration(PEA)has revolutionized cataract surgery.However,the production of ultrasound energy is associated with heat generation that can result in damage to corneal incision.Thermal damage to the corneal incision may result in difficulty with wound closure and consequent risk of wound leakage,as well as damage to the adjacent corneal stroma and endothelium.The heat around the tip not only causes damage to the corneal incision,but also give rise to an increase of temperature in the anterior chamber during PEA,which ultimately injures corneal endothelium.Different ultrasound durations,ultrasound modes,ultrasound energies and ultrasound instruments have certain effects on the temperature of anterior chamber.Clinicians should try to use lower ultrasound energy for PEA in pulse mode and decrease the duration of ultrasound.In addition,various ophthalmic viscosurgical devices,as well as the continuous irrigation of irrigating solution,are critical factors influencing the temperature of anterior chamber during phacoemulsification.

关 键 词：超声乳化白内障摘除术 前房温度 角膜热损伤 

分 类 号：R779.66[医药卫生—眼科]