不同灌注液在白内障超声乳化术中对角膜内皮细胞形态的影响研究  

To study the effects of different perfusates on the morphology of corneal endothelial cells during phacoemulsification

作　　者：杨德强 张良燕 邢中波 张保廷 Yang Deqiang;Zhang Liangyan;Xing Zhongbo;Zhang Baoting(Aier Eye Wanzhou Sunshine Hospital,Chongqing 404000,China)

机构地区：[1]重庆万州爱尔阳光眼科医院,重庆404000

出　　处：《首都食品与医药》2024年第13期59-61,共3页Capital Food Medicine

摘　　要：目的探讨不同灌注液在白内障超声乳化术中对角膜内皮细胞形态的影响。方法回顾性分析重庆万州爱尔阳光眼科医院2023年1月-2024年1月期间诊断为老年性白内障且均进行手术治疗的120例白内障患者,根据术中灌注液的不同,分为A组(n=60,普通乳酸钠林格液)和B组(n=60,500ml乳酸钠林格液+50%葡萄糖0.9ml+维生素C 1mg)。比较两组术后3d、1周中央角膜厚度、角膜内皮细胞计数、角膜内皮细胞形态学、前房炎症反应、角膜水肿、眼压、黄斑水肿、视力及恢复时间等指标。结果两组术后3d、术后1周角膜内皮细胞密度及六角形细胞比例相比术前均显著降低(P<0.05),且B组在各时间点相比A组降低更为明显(P<0.05);与术前相比,两组在术后3d中央角膜厚度均增加(P<0.05),术后1周均降低(P<0.05),两组在各时间点的中央角膜厚度无明显差异(P>0.05);两组术后3d、术后1周角膜内皮细胞变异系数相比术前均显著升高(P<0.05),且B组在各时间点相比A组升高更为明显(P<0.05);两组术后3d、术后1周相比术前视力值均显著降低(P<0.05)。与A组相比,B组在各时间点视力值均显著下降(P<0.05);B组术后并发症总发生率低于A组(P<0.05)。结论改良的乳酸钠林格液对角膜内皮细胞具有显著保护作用且可有效减轻角膜水肿及术后炎症反应。Objective To investigate the effects of different perfusates on the morphology of corneal endothelial cells during phacoemulsification of cataracts.Methods A retrospective analysis was performed for 120 cataract patients diagnosed with senile cataract in Aier Eye Wanzhou Sunshine Hospital from January 2023 to January 2024,and were divided into group A(n=60,ordinary sodium lactate Ringer's solution)and group B(n=60,500 ml sodium lactate Ringer's solution+50%glucose 0.9ml+vitamin C 1mg)according to the different intraoperative perfusate.The central corneal thickness,corneal endothelial cell count,corneal endothelial cell morphology,anterior chamber inflammatory response,corneal edema,intraocular pressure,macular edema,visual acuity and recovery time were compared between the two groups at 3 days and 1 week after surgery.Results The density of corneal endothelial cells and the proportion of hexagonal cells in the two groups were significantly decreased at 3 days and 1 week after surgery(P<0.05),and the decrease in group B was more significant than that in group A at each time point(P<0.05),compared with the preoperative period,the central corneal thickness in both groups increased at 3 days after surgery(P<0.05)and decreased at 1 week after surgery(P<0.05),and there was no significant difference in the central corneal thickness between the two groups at each time point(P>0.05).The coefficient of variation of corneal endothelial cells was significantly increased at 1 week after operation(P<0.05),and the increase in group B was more significant than that in group A at each time point(P<0.05),and the visual acuity values in both groups were significantly decreased at 3 days after surgery and 1 week after surgery(P<0.05).Compared with group A,group B had significantly decreased visual acuity at all time points(P<0.05),and the total incidence of postoperative complications in group B was lower than that in group A(P<0.05).Conclusion The modified sodium lactate Ringer's solution has a significant protective effect on corn

关 键 词：白内障超声乳化术 灌注液 角膜内皮细胞 

分 类 号：R776.1[医药卫生—眼科]