巩膜电凝对小切口白内障囊外摘除术后切口愈合及角膜散光的临床及病理研究  

Clinical and pathological studies on effects of scleral cautery on incisional cicatrization and postoperative astigmatism after extracapsular cataract extirpation with small incision

作　　者：汤欣[1] 杨瑞波[1] 张军[1] 孙慧敏[1] 

机构地区：[1]天津医科大学眼科中心,天津300070

出　　处：《天津医科大学学报》2005年第2期247-249,共3页Journal of Tianjin Medical University

摘　　要：目的:研究巩膜电凝对小切口白内障囊外摘除术后切口愈合及角膜散光的影响。方法:应用角膜地形图仪比较巩膜电凝组(A组)与非电凝组(B组)白内障患者术后各时期角膜散光的变化,并通过裂隙灯观察两组术后各时期眼前房反应。此外通过动物实验(家兔),应用核仁组成区相关嗜银蛋白(AgNORs)表达成纤维细胞增殖活性,观察巩膜电凝组(实验组)与非电凝组(对照组)术后各时期手术切口愈合情况,分析巩膜电凝对手术切口愈合病理过程的影响。结果:术后1周,A组角膜散光小于B组(P<0.05),随时间推移,两组角膜散光趋于一致(P>0.05);B组术后发生浅前房、切口渗漏者分别有1例(2.94%)、3例(8.82%),A组无1例发生相关并发症;术后7、15天,实验组家兔成纤维细胞核内AgNORs的平均光密度高于对照组(P<0.05),术后30天两组趋于一致(P>0.05)。结论:巩膜电凝用于小切口白内障囊外摘除术时,不仅可减少术后早期手术源性角膜散光,增强切口稳定性,且可促进切口愈合,避免术后浅前房、切口渗漏等并发症的发生。Objective To study the effects of scleral cautery on incisional cicatrization and postoperative astigmatism after extracapsular cataract extirpation with small incision. Methods Applying computer-assisted corneal topography to studying the corneal astigmatism of cataract patients between scleral cautery group(A group) and scleral non-cautery group(B group) during different periods after postoperation. Applying slit-light to observing the reaction of anterior chamber after cataract surgery. Through animal experiments(rabbits) and applying argyrophil proteins of the nucleolar organizer(AgNORs) to expressing the activity of fibroblast which could be used to analysis the difference of the healing process between cautery group and control group. Results One week after postoperation corneal astigmatism of group A was smaller than group B (P<0.05). Soon after wards corneal astigmatism between two groups was same there was no statistical significance between two groups (P>0.05). The rate of flat anterior chamber and incisional seepage was 2.94%(1 eye) and 8.82%(3 eyes)in group B respectively but was zero in group A. The average optical density of AgNORs in fibroblasts in rabbit eyes was higher in cautery group than in control group on 7 days and 15 days after postoperation (P<0.05) it was same between two groups 30 days after postoperation (P>0.05). Conclusion As one of the regular steps of cataract surgery scleral cautery can’t only reduce surgical induced astigmatism and stabilize the incision but it can promote the healing process of incision rare complications such as flat anterior chamber and incisional seepage. Scleral cautery is a safe simple and effective surgical step.

关 键 词：巩膜电凝 白内障 散光 切口愈合 核仁组成区相关嗜银蛋白 

分 类 号：R776.1[医药卫生—眼科]