同轴微切口超声乳化术与标准切口超声乳化术对角膜内皮细胞的影响  

Effect of micro＇coaxial phacoemulsification and standard phacoemulsification on corneal endothelial cell

作　　者：张瑞帆[1] 吴峥峥[1] 陈波[1] 

机构地区：[1]四川省医学科学院四川省人民医院眼科,成都610072

出　　处：《中国实用眼科杂志》2013年第3期289-292,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的比较白内障同轴微切口超声乳化术与标准切口超声乳化术对角膜内皮细胞的影响。方法选择年龄相关性白内障患者，随机分为2组：3．0mm切口组55例78只眼，2．2mm切口组51例72只眼，分别行3．0mm或2．2mm透明角膜隧道切口同轴白内障超声乳化术。术后1周、1月和6月随访，观察角膜内皮细胞计数、角膜内皮六边形细胞百分率和中央角膜厚度。结果3．0mm切口组和2．2mm切口组术后随时间推移角膜内皮细胞均进行性丢失，术后1周、1月、6月角膜内皮细胞计数均较术前减少，且差异均有统计学意义（P〈0．05）。2．2mm切口组在术后各时间点角膜内皮细胞损失率均低于3．0mm组，2组比较差异均有统计学意义（P〈0．05）。术后1周时2组角膜六边形细胞百分率均明显下降，在术后1月、6月逐步有所恢复，但较术前减少，差异均有统计学意义（P〈O．05）。术后各时间点2．2mm组角膜六边形细胞百分率均高于3．0mm组，2组比较差异均有统计学意义（P〈0．05）。中央角膜厚度在2组中术前与术后及术后各时间点2组间差异均无统计学意义（P〉0．05）。结论同轴微切口超声乳化术与标准切口超声乳化术相比，对角膜内皮细胞影响更小，角膜安全性更高。ObJective To compare the effect of micro-coaxial phacoemulsification and standard-incision phacoemulsification on corneal endothelial cell. Methods Patients with age-related cataract were randomly divided into two groups. Standard-incision （3.0mm） group （55 patients, 78 eyes） uniderwent phacoemulsification through 3.0mm incisions, and micro-coaxial （2.2mm） group （51 patients, 72 eyes） underwent phacoemulsification through 2.2mm incisions. The corneal endothelial cell count, percentage of hexagonal cells and central corneal thickness were observed at 1 week, 1 month and 6 months after operation. Results The corneal endothelial cell count of patients in both groups was lost over time. All the corneal endothelial cell count of patients after surgery were less than the pre- operative, and there were statistical differences （all P 〈0.05）. There were statistical differences in en- dothelial cell counting loss rate between two groups at 1 week, 1 month and 6 months after opera- tion （all P 〈0.05）, and the endothelial cell counting loss rate of micro-coaxial group was always less than the standard-incision grodp. The percentage of hexagonal cells in both group were de- creased at 1 week after operation, and had gradually regeneration at 1 month and 6 months after op- eration, but still less than pre-operation, and there were statistical differences （all P 〈0.05）. There were statistical differences in percentage of hexagonal cells between two groups at 1 week,1 month and 6 months after operation （all P 〈0.05）. There were no statistical differences in central comeal thickness between pre-operation and post-operation in neither two groups. There were no statistical differences in central corneal thickness between two groups at 1 week, 1 month and 6 months after operation （all P〉0.05）. Conclusions The micro-coaxial phaeoemulsifieation has less impact on corneal endothelial cell and higher corneal security than the standard-incision phacoemulsifieation.

关 键 词：微切口 超声乳化白内障手术 角膜内皮细胞 

分 类 号：R779.66[医药卫生—眼科]