超声乳化白内障手术后患者角膜内皮细胞损伤的研究

目的:探讨超声乳化白内障手术患者角膜内皮细胞的损伤情况。方法:收集我院确诊为白内障的患者121例,随机分配为微切口组与常规切口组。常规切口组采用3.0 mm切口超声乳化白内障手术方案,微切口组采用1.8 mm小切口超声乳化白内障手术。手术前、手术后1日、7日、1个月、3个月监测患者角膜内皮细胞密度、六角形细胞比例、角膜内皮细胞变异系数及中央角膜厚度。结果:与治疗前相比,两组患者手术后1日、7日、1个月、3个月的角膜内皮细胞密度、六角形细胞比例及角膜内皮细胞变异系数均较治疗前显著降低(P0.05);手术后1日、7日时,两组患者的中央角膜厚度均较手术前明显变薄,有统计学差异(P0.05);手术后1个月、3个月,两组患者的中央角膜厚度均呈降低趋势,最终与手术前相似。微切口组患者不同时点六角形细胞比例与同期常规切口组比较均显著升高,角膜内皮细胞变异系数与同期常规切口组比较均明显降低有统计学差异(P0.05)。两组患者手术前后不同时间点角膜内皮细胞密度、中央角膜厚度组间比较均无统计学差异(P0.05)。结论:超声乳化白内障手术后患者角膜内皮细胞损伤与手术切口有相关性,缩小手术面积的小切口手术使术后修复增快,安全有效,适宜临床推广。

A Study on the Corneal Endothelial Cell Injury of Patients with Phacoemulsification Cataract Surgery

Objective:To investigate the corneal endothelial cell injury of patients with cataract who had taken the phacoemulsification.Methods:121 patients with cataract were randomly assigned to the small incision group and the conventional incision group. The patients in the conventional incision group were treated by phacoemulsification cataract surgery with 3 mm incision, while the patients in the small incision group were treated by phacoemulsification cataract surgery with 1.8 mmincision. Then the corneal endothelial status of the patients in both groups were observed and compared before and after the surgery.Results:Compared with before treatment, the corneal endothelial cell density, hexagonal cell ratio and corneal endothelial cell variation coefficient of patients in both groups were significantly decreased on the 1st, 7th day, 1st and 3rd month after surgery (P<0.05). On the 7th day after surgery, patients with central corneal thickness were significantly thinner than before surgery(P<0.05). On the 1st month after surgery, the central corneal thickness reduced, and ultimately was similar to that before surgery. The percentage of hexagonal cells was significantly higher than that in the same period. The variation coefficient of corneal endothelial cells were significantly lower than those of the conventional incision group(P<0. 05). There was no significant difference in the corneal endothelial cell density and central corneal thickness between two groups before and after operation (P>0.05).Conclusion:Corneal endothelial cell injury and surgical incision had correlation with the surgical incision, and the small incision operation could reduce the operation area, so that it could be repaired quickly, safely and effectively, and is suitable for clinical application.