OBJECTIVE Current literature demonstrates a lack of comparative in vivo studies regarding laparoscopic lens fogging (LLF). This randomized trial aimed to compare 3 popular methods of minimizing or reducing LLF in laparoscopic surgery by heating the lens using warm saline, applying anti-fog solution to the lens, and rubbing the lens with chlorhexidine solution. METHODS Ninety-six participants underwent randomization to be allocated in control (n = 24), warm saline (n = 24), anti-fog solution (n = 24), and chlorhexidine groups (n = 24). The primary outcome measure was the severity of LLF during the first 3 min after laparoscope insertion into the abdominal cavity. The severity of LLF was rated on a 10-point visual clarity scale ranging from 0 (clearest) to 10 (foggiest). The secondary outcome measures were (1) the severity of LLF during the remaining operative time other than the first 3 min, (2) the number of lens cleansings, and (3) the total time required to clean the lens. RESULTS Lens fogging during the first 3 min and remaining operative time other than the first 3 min was significantly decreased in the warm saline group compared to that in the other 3 groups (all, P < 0.001). In post hoc analysis, the anti-fog solution group was significantly foggier than the warm saline group, but clearer than the chlorhexidine and control groups. The number of lens cleansings and total time required to clean the lens were significantly lower in the warm saline and anti-fog solution groups than in the chlorhexidine and control groups (all, P < 0.05). CONCLUSION The use of warm saline leads to significantly fewer fogging events than the use of anti-fog solution or chlorhexidine solution, resulting in an improved continuity of surgery.

中文翻译：

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使用Anti-fog溶液，waRm盐水和洗必泰溶液（CLEAR）进行的腹腔镜LEns除雾的随机比较。

目的目前的文献表明缺乏关于腹腔镜晶状体雾化（LLF）的体内比较研究。这项随机试验旨在比较3种常用的在腹腔镜手术中最大程度地减少或减少LLF的方法，方法是使用温盐水加热晶状体，在晶状体上涂防雾剂，然后用洗必泰溶液摩擦晶状体。方法对96名参与者进行了随机分配，分别分为对照组（n = 24），温盐水（n = 24），抗雾溶液（n = 24）和洗必泰组（n = 24）。主要结局指标是腹腔镜插入腹腔后的前3分钟内LLF的严重程度。LLF的严重程度以从0（最清晰）到10（最雾）的10点视觉清晰度等级进行评分。次要结果指标是（1）除前3分钟外，剩余手术时间内LLF的严重程度；（2）晶状体清洁次数；（3）清洁晶状体所需的总时间。结果与其他3组相比，温盐水组在前3分钟和除前3分钟外的剩余手术时间内的雾度显着降低（所有，P <0.001）。在事后分析中，防雾溶液组的雾明显比温盐水组大，但比洗必泰和对照组更为清晰。在温盐水和防雾溶液组中，清洗透镜的次数和清洗透镜所需的总时间明显少于洗必泰和对照组（所有，P <0.05）。