视网膜脱离行超声乳化联合玻璃体切除术对角膜内皮细胞的影响  

Effect on corneal endothelial cells due to phacoemulsification and vitrectomy for retinal detachment

作　　者：张贵华[1] 陈伟奇[1] 陈浩宇[1] 林杜生[1] 郑建龙[1] 

机构地区：[1]汕头大学·香港中文大学联合汕头国际眼科中心,广东515041

出　　处：《中华眼外伤职业眼病杂志》2015年第2期107-111,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨孔源性视网膜脱离行超声乳化联合玻璃体切除术对角膜内皮细胞的影响。方法回顾性分析2010年5月至2012年8月在我院行晶状体超声乳化联合玻璃体切除术治疗孔源性视网膜脱离137例的资料。分别于术前及术后3个月进行角膜内皮镜等检查，比较后囊完整组与后囊破裂组的角膜内皮细胞丢失率，并比较后囊完整时全氟丙烷（C3F8）填充组与硅油填充组术后角膜内皮细胞丢失率。采用多元回归分析患者的年龄、性别、超声乳化绝对时间、手术时间、后囊状态及眼内填充物与角膜内皮细胞丢失率的相关性。结果各组术后角膜内皮细胞密度均较术前明显减少（P〈0．01），角膜内皮细胞平均丢失率为（12．13±9．91）％。后囊破裂组术后角膜内皮细胞丢失率为（16．68±11．04）％，高于后囊完整组的（11．16±9．43）％，P〈0．05）；后囊完整时C3F8填充组与硅油填充组术后角膜内皮细胞丢失率差别无统计学意义（P〉0．05）。多元回归分析显示超声乳化绝对时间越长，手术时间越长，角膜内皮细胞丢失率越高。结论晶状体超声乳化联合玻璃体切除术治疗孔源性视网膜脱离可引起患者术后角膜内皮细胞丢失。减少超声乳化绝对时间、手术时间及保持晶状体后囊完整性可以减少角膜内皮细胞的丢失。后囊完整时，玻璃体腔填充物的性质对角膜内皮细胞丢失率没有影响。Objective To investigate the effect of combined phacoemulsification and vitrectomy on corneal endothelial ceils in rhegmatogenous retinal detachment. Methods The data of 137 rhegmatogenous retinal detachment patients who received combined phacoemulsification and vitrectomy between May 2010 and August 2012 was retrospectively analysed. Corneal endothelial cell density was examined preoperatively and 3 months postoperatively. The loss rate of corneal endothelial ceils was compared between posterior capsule intact group and posterior capsule rupture group. It was also compared between C3Fs tamponade group and silicone oil tamponade group when the posterior capsule kept intact after combined surgery; and the correlation between the age, gender, absolute phaco time, operation time, posterior capsule status, tamponade material and the loss rate of corneal endothelial cells were analyzed by multiple regression. Results The corneal endothelial cell density was significantly decreased in all groups after combined phacoemulsification and vitrectomy（P 〈 0.01 ）, and the average percentage of endothelial loss was （ 12.13 ± 9.91 ） %. The loss rate of endothelial cell was （ 16.68 ± 11.04） % in posterior capsule rupture group, which was significantly higher than the percentage of endothelial loss （11.16 ± 9.43 ）% in posterior capsule intact group（P 〈 0.05 ）. There was no statistically significant difference in the loss rate of corneal endothelial cells between C3Fs tamponade group and silicone oil tamponade group when the posterior capsule kept intactafter combined surgery （P 〉 0.05）. The positive correlation was detected between the absolute phaco time, operation time and the loss rate of corneal endothelial cells. Conclusion Combined phacoemulsification and vitrectomy can damage the corneal endothelial cells. The percentage of endothelial loss can be decreased by keeping posterior capsule intact, reducing absolute phaco time and reducing operation time. There is no significant difference in the

关 键 词：超声乳化吸出术 玻璃体切除术 细胞 角膜内皮 视网膜脱离 孔源性 

分 类 号：R779.6[医药卫生—眼科]