白内障超声乳化术后早期角膜水肿和角膜内皮细胞丢失的相关性研究  

The Correlation between early corneal swelling and corneal endothelial cell loss after phacoemulsification

作　　者：陈力迅[1] 吴玲[1] 黄瑾[1] 赵贵阳[1] 赵峰[1] 

机构地区：[1]南京医科大学附属南京第一医院眼科,江苏南京210006

出　　处：《南京医科大学学报（自然科学版）》2007年第6期612-614,618,共4页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:研究白内障超声乳化术后早期的角膜水肿和角膜内皮细胞丢失情况的相关性。方法:393例(428眼)白内障超声乳化术后患者,术前均采用OrbscanⅡ和A超仪测量角膜中央厚度,非接触角膜内皮计进行角膜中央部位的角膜内皮细胞计数;术后1天测量角膜中央厚度,162眼角膜透明进行中央角膜内皮细胞计数;术后3个月进行角膜中央厚度的测量和角膜中央内皮细胞的计数。用t检验和重复测量方差分析对数据进行比较,并且对术后3个月的角膜内皮细胞丢失率进行多元线性逐步回归分析。结果:本组病例(428眼)超声乳化术后3个月角膜内皮细胞丢失率为1.56%～59.30%,平均(18.34±11.63)%;各变量中超乳时间、晶体核分级、两种方法测量的术后第1天角膜厚度增加率与其呈显著性相关(P<0.05)。结论:白内障超声乳化术后早期的角膜水肿和角膜内皮细胞丢失呈显著性相关,术后第1天的角膜厚度的测量可以作为对术后角膜内皮细胞丢失情况的评估的有效的方法。Objective：To evaluate postoperative corneal swelling as a predictor of corneal endothelial cell loss after phaeoemulsifieation cataract surgery. Methods：This study included 428 eyes which were performed routine phaeoemulsification surgery. Ultrasonic paehymetry and endothelial photography of the central of the cornea and Orbsean Ⅱ slit-scan tomography were performed preoperatively, on the the first day after surgery and three months after surgery. SPSS 13.0 was used for statistical calculations. Independent-Samples t test and repeated measures were used to test differences and a backward stepwise multiple regression analysis were performed to indentify the variables independently contributing to the corneal endothelial cell loss. Results： The ratio of endothelia cell loss 3 months after phaeoemulsifieation cataract surgery was 18.34 =1： 11.63% from 1.56% to 59.30% in this study. It was closely related to phaeo time, nuclear hardness and corneal paehymetry chang to first day after surgery. Conclusion：In this study, the degree of permanent corneal endothelial damage had significant correlation with the degree of early postoperative corneal swelling. Measuring the difference in phaehymetry at postoperative first day is a useful way to assess the effects on the corneal endothelium exerted by the phaeoemulsifieation procedure.

关 键 词：白内障 超声乳化术 角膜内皮细胞 

分 类 号：R776.1[医药卫生—眼科]