Amaç: K ırk beş derece Intrepid Dengeli ve 30 derece Ozil fako iğnesi kullanılarak yapılan torsiyonel fakoemülsifikasyon sonuçlarının karşılaştırılması. Gereç ve Yöntemler: Bu retrospektif çalışmaya Ekim 2018- Eylül 2019 tarihleri arasında evre 2-4 senil katarakt nedeniyle ameliyat olmuş ve en az 1 ay takip edilen 120 hasta dâhil edildi. Cerrahi sırasında kullanılan fako iğnesine göre 2 grup oluşturuldu. 45 derece Intrepid Dengeli fako iğnesi kullanılan 60 hasta Grup 1'e, 30 derece Ozil fako iğnesi kullanılan 60 hasta Grup 2'ye alındı. Fako süresi, kümülatif yayılan enerji, ortalama fako gücü, ortalama torsiyonel genlik, kullanılan sıvı miktarı, ortalama aspirasyon zamanı ve preoperatif, postoperatif en iyi düzeltilmiş görme keskinliği, santral kornea kalınlığı verileri kaydedildi. Bulgular: Her 2 grubun katarakt sertlik derecesi (Lens Opacification Classification System III, Grup 1=3,57±0,54, Grup 2=3,62±0,62) benzerdi (p=0,242). Ortalama fako süresi, kümülatif yayılan enerji, fako gücü, torsiyonel genlik, Grup 1'de sırasıyla 46,71±12,61 sn, 5,65±2,39, %13,57±5,85, %29,69±7,52 iken, Grup 2'de sırasıyla 51,89±18,41 sn, 10,98±4,61, %25,73±4,77, %52,63±7,58 idi. Intrepid Dengeli tip grubunda diğer gruba göre ortalama kümülatif yayılan enerji, fako gücü, torsiyonel genlik daha düşük saptandı (p<0,01). Kullanılan sıvı miktarı Intrepid Dengeli grubunda diğer gruba göre istatiksel olarak anlamlı derecede düşük iken (p=0,032), aspirasyon zamanı her 2 grupta benzer saptandı (p=0,285). Sonuç: Intrepid Dengeli fako iğnesi ile yapılan torsiyonel fakoemülsifikasyon cerrahisinin daha düşük enerji, daha düşük ortalama fako gücü ve ortalama torsiyonel genlik sağlayarak Ozil fako iğnesine göre daha etkin olduğu görüldü.
Anahtar Kelimeler: Fakoemülsifikasyon; Intrepid dengeli fako iğnesi; Ozil fako iğnesi; katarakt
Objective: To compare the outcomes of phacoemulsification performed with 45-degree Intrepid Balanced and 30-degree Ozil phaco tips. Material and Methods: One hundred twenty patients who had surgery because of grade 2-4 cataract between October 2018 and September 2019 and were followed for at least one month were included in this retrospective study. 2 groups were created according to the type of phaco tip used durıng surgery. Sixty eyes that underwent torsional phacoemulsification surgery using 45-degree Intrepid Balanced tip included in Group 1 and 60 eyes operated with 30-degree Ozil tip included in Group 2. ultrasound time (UST), cumulative dissipated energy (CDE), average phaco power, average torsional amplitude, the mean volume of balanced salt solution used, mean aspiration time, and preoperative, postoperative best-corrected visual acuity, central corneal thickness were recorded. Results: Cataract grades of both groups (Lens Opacification Classification System III, Group 1=3.57±0.54, Group 2=3.62±0.62) were similar (p=0.242). The mean UST, CDE, average phaco power, average torsional amplitude were 46.71±12.61 seconds, 5.65±2.39, 13.57± 5.85%, 29.69±7.52% in Group 1 and 51.89±18.41 seconds, 10.98± 4.61, 25.73±4.77%, 52.63±7.58% in Group 2, respectively. The mean CDE, average phaco power, and average torsional amplitude were significantly lower in the Intrepid Balanced phaco tip group (p
Keywords: Phacoemulsification; Intrepid balanced phaco tip; Ozil phaco tip; cataract
- de Silva SR, Riaz Y, Evans JR. Phacoemulsification with posterior chamber intraocular lens versus extracapsular cataract extraction (EC CE) with posterior chamber intraocular lens for age-related cataract. Cochrane Database Syst Rev. 2014;(1):CD008812. [Crossref] [PubMed]
- Liu Y, Zeng M, Liu X, Luo L, Yuan Z, Xia Y, et al. Torsional mode versus conventional ultrasound mode phacoemulsification: randomized comparative clinical study. J Cataract Refract Surg. 2007;33(2):287-92. [Crossref] [PubMed]
- Miyoshi T, Yoshida H. Emulsification action of longitudinal and torsional ultrasound tips and the effect on treatment of the nucleus during phacoemulsification. J Cataract Refract Surg. 2010;36(7):1201-6. [Crossref] [PubMed]
- Oğuzhan H, Helvacıoğlu İF, Durak İ. Fako Sistemleri [Phaco systems]. Türkiye Klinikleri J Ophthalmol Special Topics. Multifokal Göz Içi Lensler; 2019: 28-34. [Link]
- Helvacioglu F, Sencan S, Tunc Z, Yeter C. Torsional phacoemulsification and tip selection. Turk J Ophthalmol. 2014;44:392-5. [Crossref]
- Helvacioglu F, Yeter C, Tunc Z, Sencan S. Outcomes of torsional microcoaxial phacoemulsification performed by 12-degree and 22-degree bent tips. J Cataract Refract Surg. 2013;39(8):1219-25. [Crossref] [PubMed]
- Helvacioglu F, Sencan S, Yeter C, Tunc Z, Uyar OM. Outcomes of torsional microcoaxial phacoemulsification using tips with 30-degree and 45-degree aperture angles. J Cataract Refract Surg. 2014;40(3):362-8. [Crossref] [PubMed]
- Chylack LT Jr, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL, et al. The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol. 1993;111(6):831-6. [Crossref] [PubMed]
- Davison JA. Cumulative tip travel and implied followability of longitudinal and torsional phacoemulsification. J Cataract Refract Surg. 2008;34(6):986-90. [Crossref] [PubMed]
- Chen M, Anderson E, Hill G, Chen JJ, Patrianakos T. Comparison of cumulative dissipated energy between the Infiniti and Centurion phacoemulsification systems. Clin Ophthalmol. 2015;9:1367-72. Erratum in: Clin Ophthalmol. 2015;9:1475. [Crossref] [PubMed] [PMC]
- Demircan S, Ataş M, Göktaş E, Başkan B. Comparison of 45-degree Kelman and 45-degree balanced phaco tip designs in torsional microcoaxial phacoemulsification. Int J Ophthalmol. 2015;8(6):1168-72. [PubMed] [PMC]
- Yoo A, Nam KY, Tchah H, Kim MJ. Heat generation and efficiency of a new modified phaco tip and sleeve. PLoS One. 2016;11(8): e0159049. [Crossref] [PubMed] [PMC]
- Khokhar S, Aron N, Sen S, Pillay G, Agarwal E. Effect of balanced phacoemulsification tip on the outcomes of torsional phacoemulsification using an active-fluidics system. J Cataract Refract Surg. 2017;43(1):22-8. [Crossref] [PubMed]
- Aron N, Sen S, Khokhar S. Comment on "Comparison of 45-degree Kelman and 45-degree balanced phaco tip designs in torsional microcoaxial phacoemulsification". Int J Ophthalmol. 2017;10(8):1334-6. [PubMed] [PMC]
.: Process List