基于AS-OCT评估白内障术后发生角膜水肿的影响因素  

Assessment of influencing factors of corneal edema after cataract surgery based on AS-OCT

作　　者：胡金维 胡淑琼 HU Jinwei;HU Shuqiong(Xi'an Aier Eye Hospital,Xi'an 710000;Jingzhou Hospital of Traditional Chinese Medicine,Jingzhou 434000;Jingzhou Aier Eye Hospital,Jingzhou 434000,China)

机构地区：[1]西安爱尔眼科医院,陕西西安710000 [2]荆州市中医医院,湖北荆州434000 [3]荆州爱尔眼科医院,湖北荆州434000

出　　处：《临床医学研究与实践》2024年第34期38-42,共5页Clinical Research and Practice

基　　金：荆州市科技局市厅级项目(No.2022HC43)。

摘　　要：目的采用眼前节相干光断层扫描仪(AS-OCT)对白内障超声乳化联合人工晶体植入术后角膜水肿进行分级,分析发生角膜水肿的影响因素。方法选取2022年1月至2023年12月于荆州爱尔眼科医院行白内障超声乳化联合人工晶体植入术的234例(234眼)患者的临床资料,根据是否发生角膜水肿分为水肿组和非水肿组。统计所有患者角膜水肿分级情况,比较0~4级角膜水肿患者的角膜厚度变化量,分析白内障术后发生角膜水肿的影响因素。结果234眼中165眼未发生角膜水肿(0级),占比70.51%;69眼发生角膜水肿,占比29.49%,其中1、2、3、4级分别为42、19、6、2眼,占比分别为17.95%、8.12%、2.56%、0.85%。0~4级角膜水肿患者的术后角膜厚度、角膜厚度增加量、角膜厚度增加比比较,差异具有统计学意义(P<0.05)。单因素结果显示,两组的年龄、合并糖尿病、晶状体核硬度Ⅳ~Ⅴ度、前房深度(ACD)≤3.0 mm、术中超声乳化累积能量复合参数(AECP)≥60%、术中发生角膜后弹力层脱离(DMD)、手术切口靠前情况比较,差异具有统计学意义(P<0.05)。多因素二元Logistic回归分析结果显示,年龄≥72岁、合并糖尿病、晶状体核硬度Ⅳ~Ⅴ度、ACD≤3.0 mm、术中超声乳化AECP≥60%、术中发生DMD、手术切口靠前是白内障术后发生角膜水肿的危险因素(P<0.05)。结论AS-OCT应用于白内障术后角膜水肿的量化分级具有一定价值;年龄≥72岁、合并糖尿病、晶状体核硬度Ⅳ~Ⅴ度、ACD≤3.0 mm、术中超声乳化AECP≥60%、术中发生DMD、手术切口靠前是白内障术后发生角膜水肿的危险因素。Objective To classify corneal edema after phacoemulsification combined with intraocular lens implantation by anterior segment optical coherence tomography(AS-OCT),and to analyze the influencing factors of corneal edema.Methods The clinical data of 234 patients(234 eyes)who underwent phacoemulsification combined with intraocular lens implantation in Jingzhou Aier Eye Hospital from January 2022 to December 2023 were selected,according to whether corneal edema occurred,the patients were divided into edema group and non-edema group.The grading of corneal edema in all patients was counted,the changes of corneal thickness in patients with grade 0 to 4 corneal edema were compared,and the influencing factors of corneal edema after cataract surgery were analyzed.Results There was no corneal edema(grade 0)in 165 eyes of 234 eyes,accounting for 70.51%;corneal edema occurred in 69 eyes,accounting for 29.49%,of which 42,19,6 and 2 eyes were grade 1,grade 2,grade 3 and grade 4,accounting for 17.95%,8.12%,2.56%and 0.85%,respectively.There were statistically significant differences in postoperative corneal thickness,corneal thickness increase and corneal thickness increase ratio among patients with grade 0 to 4 corneal edema(P<0.05).Univariate analysis results showed that there were statistically significant differences between the two groups in age,accompanying diabetes mellitus,lens nucleus hardnessⅣtoⅤdegree,anterior chamber depth(ACD)≤3.0 mm,intraoperative phacoemulsification accumulated energy complex parameter(AECP)≥60%,intraoperative occurrence descemet's membrane detachment(DMD)and surgical incision by forward(P<0.05).Multivariate binary Logistic regression analysis results showed that age≥72 years,accompanying diabetes mellitus,lens nucleus hardnessⅣtoⅤdegree,ACD≤3.0 mm,intraoperative phacoemulsification AECP≥60%,intraoperative occurrence DMD and surgical incision by forward were risk factors for corneal edema after cataract surgery(P<0.05).Conclusion The application of AS-OCT in the quantitative gradi

关 键 词：白内障 超声乳化 眼前节相干光断层扫描仪 角膜水肿 

分 类 号：R779.6[医药卫生—眼科]