单一切口与双切口青光眼白内障联合手术对角膜内皮细胞与散光影响  

Changes in corneal endothelial cell and corneal astigmatism after one-site vs. two-site phacotrabeculectomy

作　　者：赵太宏[1] 王林农[1] 李中国[1] 

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)眼科,210006

出　　处：《临床眼科杂志》2015年第5期410-412,共3页Journal of Clinical Ophthalmology

摘　　要：目的对比观察单一切口和双切口两种不同手术切口方式对于青光眼白内障联合术后角膜内皮和散光的影响,为手术切口方式的选择提供理论依据。方法分别采用上方同一切口白内障超声乳化摘除人工晶体植入联合小梁切除以及经颞侧透明角膜切口白内障超声乳化摘除折叠型人工晶体植入联合上方切口小梁切除治疗青光眼合并有白内障患者41例(41只眼)。观察术后1周、3个月、6个月、12个月两种不同切口手术方式对患者角膜内皮细胞及屈光状态的影响。结果与术前相比,术后1周、3个月、6个月、12个月两种不同切口手术方式患者角膜内皮细胞计数均显著降低,且两组间比较具有统计学差异,双切口组角膜内皮细胞丢失更加严重;术后各时间点平均角膜散光度均增加但与术前相比差异均无显著性差异,且两组间比较亦无统计学差异。结论单一切口和双切口两种不同切口方式的青光眼白内障联合手术均可导致角膜内皮细胞计数显著降低以及角膜散光度的增加,单一切口的手术方式对角膜的影响更小。Objective To compare the corneal endothelial cell counts and corneal astigmatism changes that occurred after phacotrabeculectomy performed at one-site and two-site incision. Methods Author collected 41 cases of glaucoma combined cataract patients and randomly divided them into one-side and two-site phacotrabeculectomy groups. The records of patients who had one-site and two-site phacotrabeculectomy by a single surgeon were reviewed. Ahthor collected pre- and postoperative endothelial cell counts and corneal astigmatism. Follow-up data were obtained at 1 week,3,6,and12 months. Results Postoperative endothelial cell counts were significantly lower in both one-site and two-site groups.There were significant differences between one-side and two-site groups. Endothelial cell counts were significantly lower in the two-site group. Comparisons of corneal astigmatism before surgery and on each postoperative follow-up point were not statistically significant between two groups. Conclusion Endothelial cell loss and corneal astigmatism increase occurred in both one-site and two-site groups. One-site surgery seems to cause less corneal endothelial cell damages than 2-site operation do.

关 键 词：小梁切除术 白内障摘除术 角膜散光 角膜内皮细胞 

分 类 号：R779.66[医药卫生—眼科]