23G前段玻璃体切割术在浅前房低角膜内皮细胞密度白内障手术中的应用  

23-gague anterior vitrectomy during phacoemulsification for cataract with low corneal endothelial cell density and shallow anterior chamber

作　　者：宋新志[1] 陈彬川[1] 王永成[1] 李佳佳[1] 徐一帆[1] 

机构地区：[1]郑州大学第二附属医院眼科,河南省郑州市450014

出　　处：《眼科新进展》2016年第11期1058-1060,1064,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨23 G前段玻璃体切割联合白内障超声乳化手术治疗浅前房低角膜内皮细胞密度(endothelial cell density,ECD)白内障的疗效及安全性。方法根据患者自愿原则,将2012年1月至2015年12月在郑州大学第二附属医院接受手术治疗的30例(34眼)ECD<1000 mm-2的浅前房白内障患者分为联合手术组和Phaco组。联合手术组16例(19眼),行23 G前段玻璃体切割联合白内障超声乳化术;Phaco组14例(15眼),行单纯白内障超声乳化术。术后1 d、1周及3个月检查两组患者最佳矫正视力、角膜水肿程度,同时记录术前及术后3个月ECD,观察角膜水肿消退时间、术中及术后并发症。结果术后1 d,联合手术组最佳矫正视力较术前显著增高,差异有统计学意义(P<0.05)。术后1周及3个月,两组最佳矫正视力均较术前显著增高,差异均有统计学意义(均为P<0.05)。术后1 d及1周,联合手术组最佳矫正视力均优于Phaco组,差异均有统计学意义(均为P<0.05)。术后1 d,联合手术组以1级角膜水肿为主,Phaco组以2级角膜水肿为主,两组角膜水肿程度差异有统计学意义(P<0.05)。联合手术组角膜水肿平均消退时间为1.0 d,小于Phaco组的4.0 d,差异有统计学意义(P<0.05)。术后3个月,联合手术组角膜内皮细胞丢失率为(7.86±0.76)%,低于Phaco组的(13.39±0.47)%,差异有统计学意义(P<0.05)。结论23 G前段玻璃体切割联合白内障超声乳化术安全性好,角膜内皮细胞损伤小,术后角膜水肿轻,早期视力恢复快,适用于浅前房低ECD白内障患者。Objective To investigate the outcomes and safety of 23-gague anterior vitrectomy combined with phacoemulsification for cataract with low preoperative corneal endothelial cell density （ECD） and shallow anterior chamber. Methods Thirty cases （34 eyes） with preoperative ECD of less than 1000 mm ： and shallow anterior chamaber were selected in the Second Affiliated Hospital of Zhengzhou University form January 2012 to December 2015 ,in which 16 cases （19 eyes） underwent 23-gague anterior vitrectomy combined with phacoemulsification （ combined surgery group）, 14 cases （15 eyes） underwent phacoemulsification （Phaco group）. The best corrected visual a- cuity and corneal edema were examined at postoperative 1 day, 1 week and 3 months. ECD was recorded preoperative and postoperative 3 months. The regression time of corneal edema,intraoperative and postoperative complications were observed. Results Compared with pre-operation,the best corrected visual acuity at postoperative 1 day in the combined surgery group improved significantly （P 〈 0.05 ）. The best corrected visual acuity at postoperative 1 week and 3 months in the combined surgery group and Phaco group were all better than those before surgery, there were statistical differences （all P 〈 0. 05）. The best corrected visual acuity at postoperative 1 day and 1 week in the combined surgery group were better than those in the Phaco group （ all P 〈 0.05 ）. The corneal edema in the combined surgery group and Phaco group were mainly in grade one and grade two at postoperative 1 day, respectively, there was a statistical difference （P 〈 0.05 ）. The mean regression time of corneal edema in the combined surgery group and Phaco group were 1.0 day and 4.0 days, respectively, there was statistical difference （P 〈 0.05 ）. The rates of corneal endothelial cell loss at postoperative 3 months in the combined surgery group and Phaco group were （7.86 ± 0.76 ）% and （ 13.39 ± 0.47 ）% , respectively, there was a statistical

关 键 词：23 G玻璃体切割系统 前段玻璃体切割术 低角膜内皮细胞密度 浅前房 白内障 超声乳化手术 

分 类 号：R779.66[医药卫生—眼科]