白内障超声乳化对角膜内皮细胞的相关影响因素

目的：旨在分析白内障超声乳化对角膜内皮细胞损伤的相关影响因素,以期在临床上指导白内障超乳手术的改进,提高手术质量,降低对角膜内皮细胞的损伤。方法：随机选取于我院行白内障超声乳化的125例125眼年龄相关性白内障患者,对可能影响角膜内皮细胞的多个因素进行分析。结果：各因素在术后1周和术后3个月的角膜内皮细胞损失率呈线性相关（F=2.13,P=0.017〈0.05;F=2.58,p=0.016〈0.05）;其中对超声乳化术后1周和3个月角膜内皮细胞损伤影响最强的因素均是核硬度（P=0.012,p=0.014）,其次为超乳时间（1周时P=0.005,3个月时P=0.034）。在术后1周内角膜内皮细胞损失率与核硬度、粘弹剂类型呈显著性相关（P=0.012,p=0.036）;在术后3个月与核硬度和术前角膜内皮细胞密度呈显著性相关（P=0.014,p=0.012）。结论：超乳时间、超乳能量、粘弹剂的类型、超乳模式、核硬度、术前角膜内皮细胞密度均与角膜内皮细胞的损伤有关,最危险的因素是核硬度,其次是超乳时间。

Relative Factors of Phacoemulsification on Corneal Endothelial Cells Damage

Objective： To analyze the influencing factors ofphacoemulcification on corneal endothelial cells damage, in order to improve phacoemulcification and reduce damage to the corneal endothelial cells. Methods： A total of 125 patients with 125 eyes, who underwent phacoemulcification, admitted to Qijiang District People＇s Hospital, were randomly selected, and a number of factors that may affect the corneal endothelial cell damage were analyzed. Results： All the factors were linearly related to corneal endothelial cell loss rate after 1 week and 3 months after surgery （F=2.13, P =0.017〈0.05; F=2.58,p= 0.016〈 0.05）; Among which, the strongest influencing factors are nuclear hardness （P=0.012, p=0.014）, followed by phaco time （ p=0.005 at 1 week, P=0.034 at 3 months）. Corneal endothelial cell loss rate was significantly related to nuclear hardness and viscoelastics type within 1 week after surgery （P = 0.012, p = 0.036）; And it was significantly associated with nuclear hardness and density of corneal endothelial cells before surgery （P = 0.014, p = 0.012）. Conclusion： Phaco time, phaco energy, viscoelastic type, phacoemulsification mode, nuclear hardness and the preoperative corneal cell density are all related to the damage of the corneal endothelial cell. The most dangerous factor is nuclear hardness, followed by phacoemulsification time.