白内障手术复方氯化钠灌注对角膜内皮细胞的影响  

The effect of phacoemulsification on corneal endothelial cell using Ringer＇ s injection as anteriorchamber irrigating solution

作　　者：莫劲松[1] 张翠薇 张桐[1] 秦波[1] 

机构地区：[1]深圳市眼科医院,广东深圳518000 [2]深圳市保健委员会办公室专家门诊部

出　　处：《中华眼外伤职业眼病杂志》2012年第7期508-510,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察用复方氯化钠溶液作为前房灌注液的白内障超声乳化术联合人工晶状体植入术对角膜内皮细胞（CEC）的形态和数量影响。方法选择826例（1017眼）白内障采用颞侧透明角膜切口超声乳化术和人工晶状体植入术，用复方氯化钠溶液作为灌注液，分别于术前及术后3个月用角膜内皮细胞分析仪检查角膜内皮细胞的密度、形态等指标。结果手术前和术后3个月的角膜内皮细胞密度分别为（2521．81±102．55）／mm2和（2111．65±207．32）／mm2，内皮细胞平均丢失率为15．64％。六角形细胞比率分别为（52．23±11．91）％和（36．47±10．35）％（P〈0．05）。术后3个月最佳矫正远视力≥0．5者952眼，占90．6％；≥1．0者589眼，占57．9％。结论复方氯化钠溶液作为前房灌注液，对角膜内皮细胞的损害较为明显。对于年龄较大晶状体核较硬者更应慎重选择灌注液和手术方式。Objective To observe the effect on corneal endothelial ceils in phacoemulsification and IOL implantation using Ringerg solution as anterior chamber irrigating solution. Methods Clear corneal in- cision phaeoemulsification and IOL implantation were applied to cataract surgery on 1017 eyes in 826 cases. Ringerg injection was used as anterior chamber irrigating solution. Endothelium cells were observed with a corneal endothelium scope at pre-and 3 month post-operation. Results Before surgery and 3 months after surgery, the average cell density of the corneal endothelium were （2521.81±102.55 ）/mm2 and （2111.65±207.32 ）/mm2 respectively, the average cellular lost rate was 15.64%. The rate of hexagonality were （52.23±11.91 ） % and （36.47 ± 10.35 ） % Tespectively （ P 〈 0.05 ）. 3 month after surgery, 952 eyes （90.6%） attained best correct distance visial acuity of 0. 5 or better and 589 eyes （57.9%） improved to 1. 0 or better. Conclusion As anterior chamber irrigating solution, Ringerg injection and normal saline were obviously harmful to the corneal endothelial cells. For senior cases and harden nucleus cataract, the opera- tion-style and anterior chamber irrigating solution ought to be selected with caution.

关 键 词：氯化钠溶液 复方 白内障 超声乳化术 角膜内皮细胞 

分 类 号：R779.66[医药卫生—眼科]