Clinical Observation On The Application Of Hypothermic Perfusion In Phacoemulsification Of Cataract

Objective:To evaluate the safety and efficacy of hypothermic perfusion in phacoemulsification intraocular lens implantation for cataract.Methods:In this prospective randomized controlled trial,From December2019 to December 2020,40 patients with cataract phacoemulsification and intraocular lens implantation(Phaco ICL)were selected,Among them,28 eyes in the experimental group(4-11℃,Control group(about 24℃)28 eyes.Observe and record the first day before and after operation,Optimum corrected visual acuity,intraocular pressure,corneal edema grade,mean corneal cell area,coefficient of corneal variation,hexagonal cell ratio,corneal endothelial cell density,etc.on day 7 after operation The indexes,accumulated energy consumption and corneal surface temperature during operation were compared between the control group and the test group.Results:1)The corneal surface temperature was 20.24±1.37℃ in the experimental group and 25.67±1.05℃ in the control group.The corneal surface temperature of the two groups was significantly different,P<0.05,that is,the low temperature perfusion fluid could significantly reduce the local tissue temperature during operation;2)Grading observation of corneal edema-the first day after operation: there were no cases of grade 0 corneal edema and grade 4 corneal edema in the experimental group,16cases(57.1%)with grade 1 corneal edema,9 cases(32.1%)with grade 2corneal edema,3 cases(10.7%)grade 3 edema;There were no cases of grade0 corneal edema and grade 4 corneal edema in the control group,6 cases(21.4%)with grade 1 corneal edema,8 cases(64.3%)with grade 2 corneal edema,4 cases(14.3%)grade 3 edema,The degree of corneal edema was different between the two groups,P<0.05 was statistically significant,The degree of corneal edema after operation can be significantly reduced by using hypothermic perfusion fluid;3)Average corneal cell area,coefficient of corneal variation,ratio of hexagonal cells,density of corneal endothelial cells and loss of corneal endothelial cells were not significantly different between control group and experimental group(P>0.05);4)There was no significant difference in the best corrected visual acuity between the control group and the test group before,on the first day after operation,on the 7th day after operation,and on the 1st month after operation;5)The cumulative energy consumption in the experimental group was 16.19±11.77,and that of the control group was12.51±7.24.There was no significant difference between the two groups,P>0.05;6)The degree of corneal edema was positively correlated with the cumulative energy consumption(r=0.319 P<0.05),that is,the higher the cumulative energy consumption during phacoemulsification,the higher the degree of corneal edema;7)Control group and test group had no significant difference in age,sex and other general data,(P>0.05).Conclusion:The application of cryogenic perfusion in phacoemulsification of cataract is safe and can effectively reduce the temperature of local tissue so as to protect cornea and reduce the degree of corneal edema after phacoemulsification.