應用高黏稠性，高分子量之超黏喜隆(Healon G.V.)在超音波晶體乳化術中之臨床經驗

The Clinical Experience on High Molecular Weight and High Viscoelastic Agent-Healon G.V. in Cataract Removal with Phacoemulsification

張宇華(Yu-Hwa Chang) ； 何一滔(Ye-Tau Ho)

《中華民國眼科醫學會雜誌》 34卷3期 (1995/09) Pp. 349-354

https://doi.org/10.30048/ACTASOS.199509.0006

摘要

隨著超音波晶體乳化術(phacoemulsification)的流行，傳統的人工玻璃體－喜隆(Healon)已較不符合需要，因此又發展了高黏稠性(2×10^6 Cst)，而分子量達5×10^6 Dalton的超黏喜隆(Healon G.V.)作為新一代的人工玻璃體(Viscoelastic agents)。
本研究收集了各30例的白內障病例，利用Healon及Healon G.V.作超音波乳化術，在手術中觀察其特性；並在術前、術後第一週、術後三個月觀察其變化。經過三個月的觀察，在視力方面兩組並無差異。Healon組的內皮細胞損失率雖稍高，但並無統計學上之差異。Healon組的內皮細胞形狀，呈較不規則之變化，需再作進一步之觀察與研究。術後兩組各有兩例在24小時內眼壓達30mmHg以上，但48小時獲全部達正常範圍。在前房重塑(chamber creation)、前房維持(chamber maintenance)、及抗壓(pressure resistance)方面，Healon G.V．較優。作連續環狀前囊膜撕閉(Continuous curvilinear capsulorhexis)時，也因Healon G.V．的黏稠性增加而較能控制前囊撕開之方向。兩者在透明度及術後清除方面均極優良，不易有氣泡也不易殘留。
整體而言，Healon G.V．對於操作超音波乳化術，較Healon更易淤施行，更能保護組織。

並列摘要

Owing to the current increasing popularity of phacoemulsification, the high viscosity preparations (e.g. Healon G.V. 2×10^6 Cst, M.W. 5×10^6) were developed to assure the ease and safety of such technique. We collected 30 cases of cataract for each group, using Healon or Healon G.V. in phacoemulsification, to observe the change during operation one week and three months postoperatively. There was no significant difference between these two groups in visual acuity right before and three months after surgery.
The corneal endothelial cell loss rate was higher in the Healon group without statistically significant difference. However, the size and morphology of corneal endothelial cells were more irregular in Healon group, even though this needed further investigation due to lack of quantitative analysis. Both groups had two cases of rising intraocular pressure to 30mmHg or more within 24 hours postoperatively, but they all returned to normal range by 48 hours. In addition to greater viscosity, Healon G.V. had greater chamber creation, chamber maintenance and pressure resistance than Healon. So, Healon G.V. provided better control for continuous curvilinear capsulorhexis performance. Both Healon and Healon G.V. had good visual clarity and residue washing-out.
Therefore, Healon G.V. was an excellent choice for manipulation and tissue protection in phacoemulsification.

並列關鍵字

phacoemulsification ； viscoelastic agents ； Healon G.V. Healon