대한안과학회지 (Journal of The Korean Ophthalmological Society)

  • 제59권11호
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  • Pages.1017-1023
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  • 2018
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  • 0378-6471(pISSN)
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  • 2092-9374(eISSN)
대한안과학회 (The Korean Ophthalmological Society)
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수정체유화장치의 초음파 출력속도 및 자동막힘감지 기능 향상의 술 후 임상결과 비교

Clinical Effects of an Improved Pump Reaction Rate and Automatic Occlusion Sensing System in Phacoemulsification

  • 김유나 (울산대학교 의과대학 서울아산병원 안과학교실) ;
  • 이진아 (울산대학교 의과대학 서울아산병원 안과학교실) ;
  • 김재용 (울산대학교 의과대학 서울아산병원 안과학교실) ;
  • 김명준 (울산대학교 의과대학 서울아산병원 안과학교실) ;
  • 차흥원 (울산대학교 의과대학 서울아산병원 안과학교실)
  • Kim, You Na (Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jin Ah (Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jae Yong (Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Myoung Joon (Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Tchah, Hung Won (Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2018.02.14
  • 심사 : 2018.10.30
  • 발행 : 2018.11.15
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 최근 펌프조절장치와 발판의 반응속도가 빨라지고 자동막힘감지(automatic occlusion sensing) 기능이 향상되어 수술 중 흡입력과 절단력을 향상시킨 수정체유화장치가 소개된 바 있다. 본 연구에서는 수정체유화술 시행 중 여러 매개변수를 비교하여 기기의 반응속도 향상과 자동막힘감지 기능이 수정체유화술의 임상결과에 미치는 영향을 비교하고자 하였다. 대상과 방법: 단일 술자에게 수정체유화술을 시행받은 68명의 백내장 환자, 총 80안이 본 연구에 포함되었다. 기존의 기기(WhiteStar $Signature^{(R)}$ system)를 사용하여 초음파유화술을 시행한 40안을 대조군으로 하였으며, 반응속도 향상 및 자동막힘감지 기능 효과를 분석하기 위해서 향상된 기기(WhiteStar $Signature^{(R)}$ PRO system)를 사용하여 초음파유화술을 시행한 40안을 실험군으로 정하였다. 두 군 모두에서 수술 중 parameter of effective phaco time with a specific coefficient for the transversal movement expressed in seconds (EFX), 총 초음파 사용시간(ultrasound time), 유효 초음파 사용시간(effective phaco time, EPT), 평균 초음파 출력(average phaco power, AVG) 및 평형염액 사용량을 확인하였고 수술 전후 중심각막두께(central corneal thickness)를 확인하여 수술 전후의 상관관계를 독립표본검정을 통하여 분석하였다. 결과: 두 군의 비교에서 수정체혼탁도와 상관없이 Signature $PRO^{(R)}$ system에서 수술 중 적은 EFX (p<0.001), 짧은 유효 초음파 사용시간(EPT, p<0.001), 작은 평균 초음파 출력(AVG, p<0.001)을 사용함을 확인하였다. 수술 후 중심각막두께는 양 군에서 차이가 없었다. 결론: 수정체유화술을 시행함에 있어 기기의 반응속도 향상 및 자동막힘감지 기능은 수술 중 수정체 핵의 흡입력과 절단력을 높이면서도 전방을 안정적으로 유지할 수 있도록 하여 유의하게 짧은 시간 동안 적은 초음파 출력을 사용하면서 효율적인 수술이 가능하게 함을 확인하였다.

Purpose: A recently introduced phacoemulsification system, the WhiteStar $Signature^{(R)}$ PRO, has demonstrated improved nucleus followability and cutting efficiency via an improved pump regulator with a higher reaction response and an automatic occlusion sensing system. In this study, we compared various phacoemulsification parameters between the new system and an older version of the device. Methods: A total of 80 eyes of 68 patients with cataracts who had undergone phacoemulsification by a single surgeon were included in this study. Forty eyes of patients underwent phacoemulsification using the older $Signature^{(R)}$ system (WhiteStar); these patients were classified as the control group. Another 40 eyes of patients underwent phacoemulsification with the newer enhanced system, the WhiteStar $Signature^{(R)}$ PRO; these patients were assigned to the experimental group. During the operation, operative parameters, including the effective phaco time (parameter of effective phaco time with a specific coefficient for the transversal movement expressed in seconds, EFX), ultrasound time (seconds [s]), effective phacoemulsification time (EPT, s), average phacoemulsification power (AVG, %), and balanced salt solution usage, were measured to determine the performance enhancement offered by the updated system. Central corneal thickness was measured before and after surgery to compare corneal edema. The relationships between the two groups were analyzed using an independent t-test. Results: The Signature $PRO^{(R)}$ system showed a lower EFX (p < 0.001), a shorter EPT (p < 0.001), and a smaller AVG (p < 0.001). Postoperative corneal thickness did not differ significantly between the two groups. Conclusions: Comparing the efficacy of the improved reaction speed of the device and automatic occlusion sensing system in performing phacoemulsification, the updated Signature $PRO^{(R)}$ system demonstrated superior followability and cutting efficiency regardless of nuclear cataract hardness.

키워드

참고문헌

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