白内障超声乳化术后角膜水肿的观察  

Observation of corneal edema after phacoemulsification for cataract

作　　者：谢田华[1] 栾兰[1] 禹倩倩[1] 姚勇[1] 

机构地区：[1]无锡市人民医院眼科,江苏省无锡市214023

出　　处：《中国实用眼科杂志》2013年第8期978-981,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察白内障超声乳化术后角膜水肿的情况，评估角膜水肿相关的影响因素。方法临床病例自身对照研究。对2011年7～11月在无锡市人民医院眼科人院的134例患者（134只眼）行白内障冷超声乳化手术。术前记录患者年龄、性别、病史、核硬度、角膜内皮细胞密度（CED）、六边形细胞比率，术中记录超声时间、超声能量及手术时间。术后一周内观察角膜水肿程度和消退情况。结果术后85只眼（63．4％）出现不同程度角膜水肿，无一例出现角膜失代偿，且角膜水肿均于术后一周内消退。术后角膜水肿程度与年龄、核硬度、超声能量显著有统计学意义（P〈0．005），但与性别、既往眼病史、对侧眼手术史、全身病史、术眼中央角膜内皮细胞密度、六边形细胞比率、总手术时间无统计学意义（P〉0．05）。结论白内障超声乳化术后角膜水肿受到多方面因素的影响，术前充分评估手术风险，术中根据患者情况调整能量参数，提高手术技巧，最大限度地减少角膜内皮的损伤，将有效地减少白内障术后角膜水肿的发生。Objective To observe the corneal edema after cataract phacoemulsification, and evalu-ate the influence factors of corneal edema. Methods One hundred and thirty-four patients （134 eyes） scheduled for phacoemulsiflcation were selected for this clinical trial. The parameters recorded preoperative were age, gender, medical history, density of the nucleus, density of central corneal endothelial cells, and percentage of hexagonal cells. The parameters recorded intraoperative were irriga- tion time, irrigation volume, operation time and cumulative dissipated energy （CDE）. Then corneal edema during 1 week after phacoemulsification was observed and the time when the corneal edema regressed was recorded. Results There were 85 eyes （63.4%） appeared corneal edema after surgery without corneal decompensation, and all corneal edema regressed within one week. The degree of corneal edema after cataract phacoemulsiflcation were significant related with age, density of the nu- cleus and cumulative dissipated energy （CDE）, P 〈0.005）, however, gender, medical history, density of central corneal endothelial cells, percentage of hexagonal cells and total operation times were not significant predictors （P 〉0.05）. Conclusions Corneal edema after cataract phacoemulsification is in- fluenced by many factors. So make a full assessment of operation risk, improve the surgical skills and adjust irrigation parameters according to the condition of patients, will minimize the damage of corneal endothelium and reduce the occurrence of corneal edema after surgery.

关 键 词：超声乳化手术 角膜水肿 角膜内皮细胞 

分 类 号：R779.66[医药卫生—眼科]