天津医药

天津医药 ›› 2026, Vol. 54 ›› Issue (9): 913-917.doi: 10.11958/20260990

• 临床研究 • 上一篇    下一篇

锯齿内刃劈核刀在硬核白内障超声乳化吸除术中的应用效果

王秀(), 高奕晨, 毛瀚, 田芳, 魏瑞华, 杨军△()   

  1. 天津医科大学眼科医院/眼视光学院/眼科研究所， 国家眼耳鼻喉疾病临床医学研究中心天津市分中心， 天津市视网膜功能与疾病重点实验室（邮编 300384）
  • 收稿日期:2026-04-17 修回日期:2026-05-22 出版日期:2026-09-15 发布日期:2026-09-14
  • 通讯作者: △E-mail：junyang01@tmu.edu.cn
  • 作者简介:王秀（1988），女，副主任医师，主要从事白内障、高度近视和眼表疾病方面研究。E-mail：wangxiulzjzhou@163.com
  • 基金资助:
    天津市医学重点学科建设项目(TJYXZDXK-3-004A-2);天津医科大学眼科医院高水平创新型人才计划第四层次(YDYYRCXM-D2023-03)

The application effect of serrated inner blade nuclear chopper in phacoemulsification for hard nuclear cataracts

WANG Xiu(), GAO Yichen, MAO Han, TIAN Fang, WEI Ruihua, YANG Jun△()   

  1. Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
  • Received:2026-04-17 Revised:2026-05-22 Published:2026-09-15 Online:2026-09-14
  • Contact: △E-mail：junyang01@tmu.edu.cn

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摘要：

目的 评估锯齿内刃劈核刀在硬核白内障超声乳化吸除术中应用的安全性和有效性。方法 本研究为前瞻性随机对照研究。选择2022年4月—2023年4月于天津医科大学眼科医院行白内障超声乳化吸除术联合人工晶状体植入术的Ⅲ—Ⅳ级核白内障患者136例（136眼）。根据随机数字表法将入组患者分为试验组和对照组。其中试验组采用锯齿内刃劈核刀（专利号：ZL 202122407969.9），对照组采用Nagahara（Trimmer Y-C802）劈核刀。所有患者均由同一位经验丰富的白内障手术医生行常规2.2 mm微切口白内障超声乳化吸除术联合人工晶状体植入术。术中记录首次劈核是否成功、并发症发生与否、累积释放能量（CDE）、超声乳化时间（US time）。比较2组术前及术后1 d、 1周和1个月的最佳矫正远视力（BCDVA）、眼压（IOP）、中央角膜厚度（CCT）；术前和术后1个月的角膜内皮细胞密度，计算术后1个月的角膜内皮细胞丢失率；记录术后随访期间并发症的情况。结果 试验组所有病例均劈核成功，对照组有1例未劈核成功，劈核成功率差异无统计学意义（P>0.05）。2组手术过程中均无并发症发生。试验组术中CDE和US time均低于对照组（均P<0.01）。术后1 d及1周，试验组BCDVA均优于对照组（P<0.01），CCT均低于对照组（P<0.05）。各时间点2组IOP差异均无统计学意义（均P>0.05）。术后1个月，试验组角膜内皮细胞密度高于对照组，角膜内皮细胞丢失率低于对照组（均P<0.01）。2组随访期间均无手术并发症发生。结论 在Ⅲ—Ⅳ级硬核白内障超声乳化吸除手术中，应用锯齿内刃劈核刀相较Nagahara劈核刀更安全高效。

关键词: 超声乳化白内障吸除术, 劈核刀, 硬核白内障, 安全性和有效性

Abstract:

Objective To evaluate the safety and efficacy of the serrated inner blade nuclear chopper in phacoemulsification for hard nuclear cataracts. Methods This was a prospective, randomized controlled study. A total of 136 patients (136 eyes) with grade Ⅲ-Ⅳ nuclear cataract who received phacoemulsification combined with intraocular lens implantation at Tianjin Medical University Eye Hospital from April 2022 to April 2023 were enrolled. The patients were randomly assigned to either the experimental group or the control group using a random number table. The experimental group received a serrated inner blade nuclear chopper (patent No. ZL 202122407969.9), while the control group received a Nagahara chopper (Trimmer Y-C802). All surgeries were performed by the same experienced cataract surgeon using a standard 2.2 mm micro-incision phacoemulsification technique. Intraoperatively, success of the first chop attempt, occurrence of complications, cumulative dissipated energy (CDE) and ultrasound time (US time) were recorded. Best corrected distance visual acuity (BCDVA), intraocular pressure (IOP) and central corneal thickness (CCT) were measured preoperatively and at 1 day, 1 week and 1 month postoperatively. Corneal endothelial cell density was measured preoperatively and at 1 month postoperatively, and the percentage of endothelial cell loss was calculated. The occurrence of complications during the postoperative follow-up period was recorded. Results The first chop attempt was successful in all patients in the experimental group, while one patient in the control group failed. There was no significant difference between the two groups (P>0.05). No intraoperative complications occurred in either group. Intraoperatively, the experimental group showed significantly lower CDE and US time than those of the control group (both P<0.01). At 1 day and 1 week postoperatively, BCDVA was significantly better in the experimental group than that in the control group (both P<0.01), and CCT was significantly lower in the experimental group than that in the control group (P<0.05). There were no significant differences in IOP at each time point between the two groups (all P>0.05). One month after the operation, the experimental group showed significantly higher corneal endothelial cell density and a lower rate of endothelial cell loss than those of the control group (both P<0.01). There were no postoperative complications during the follow-up period in either group. Conclusion Compared with the Nagahara chopper, the serrated inner blade nuclear chopper is safer and more effective in phacoemulsification for grade Ⅲ-Ⅳ hard nuclear cataracts.

Key words: phacoemulsification, nuclear chopper, hard nuclear cataract, safety and efficacy

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