无晶状体眼行改良四点固定人工晶状体悬吊植入术后角膜内皮变化及影响因素分析  

Analysis of corneal endothelial changes and influencing factors after modified four point fixed intraocular lens suspension implantation in aphakic eyes

作　　者：陈佳菲 张月玲[1] 顾朝辉[1] 陈乾 陈强[1] Chen Jiafei;Zhang Yueling;Gu Chaohui;Chen Qian;Chen Qiang(Department of Ophthalmology,Baoding First Central Hospial,Baoding 071300,China)

机构地区：[1]保定市第一中心医院眼科,071300

出　　处：《临床眼科杂志》2024年第6期531-536,共6页Journal of Clinical Ophthalmology

基　　金：保定市科技计划项目(2141ZF240)。

摘　　要：目的观察无晶状体眼患者行改良四点固定人工晶状体悬吊植入术后角膜内皮变化,并分析其影响因素。方法回顾性病例研究。纳入2021年6月至2022年10月于我院成功行改良四点固定人工晶状体悬吊术的无晶状体眼患者78例(78只眼),记录术前、术后1个月、3个月裸眼视力(UCVA)、最佳矫正视力(BCVA)、角膜内皮细胞密度(CECs)、细胞面积变异系数(CV)、六边形比率,应用单因素分析及二元Logistic回归分析影响角膜内皮损伤的危险因素。结果术前患者UCVA为logMAR(1.21±0.34),术后1个月UCVA为logMAR(0.49±0.23),术后3个月UCVA为logMAR(0.39±0.17),三组比较有显著差异(F=772.0,P=0.00),多重比较显示术后1个月、3个月UCVA与术前比较有显著差异(P=0.00,0.00),术后3个月UCVA与术后1个月比较有显著差异(P=0.00)。术前患者BCVA为logMAR(0.52±0.76),术后1个月BCVA为logMAR(0.41±0.18),术后3个月BCVA为logMAR(0.36±0.14),三组比较无显著差异(F=2.95,P=0.08),多重比较显示术后1个月、3个月BCVA与术前比较无显著差异(P=0.54,0.16),术后3个月BCVA与术后1个月比较有显著差异(P=0.00);术前CECs为(2515.97±291.40)/mm^(2),术后1个月CECs为(2377.61±288.50)/mm^(2),术后3个月CECs为(2320.70±287.37)/mm^(2),三组比较有显著差异(F=334.9,P=0.00);多重比较显示术后1个月、术后3个月与术前比较有显著差异(P=0.00),术后3个月与术后1个月比较有显著差异(P=0.00);术前CV为(40.15±2.80)%,术后1个月CV为(42.43±3.25)%,术后3个月CV为(44.14±3.40)%,三组比较有显著差异(F=366.9,P=0.00),多重比较显示术后1个月、3个月与术前比较有显著差异(P=0.00),术后3个月与术后1个月比较有显著差异(P=0.00);术前六边形比率(42.51±5.16)%,术后1个月六边形比率(39.17±4.98)%,术后3个月六边形比率(36.03±6.14)%,三组比较有显著差异(F=103.6,P=0.00),多重比较显示术后1个月、3个月与术前比较有显著差异(P=0.00),术后3个月与术后1个Objective To observe the changes in corneal endothelium after modified four point fixed intraocular lens suspension implantation in patients with aphakia and analyze its influencing factors.Methods Retrospective cases study.78 patients(78 eyes)with aphakia who successfully underwent modified four point fixed intraocular lens suspension surgery in our hospital from June 2021 to October 2022 were included.The uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),corneal endothelial cell density(CECs),coefficient of variation(CV)of cell area,and hexagonal ratio were recorded before,at 1 and 3 months after the surgery,single factor analysis and binary logistic regression analysis were used to analyze the risk factors affecting corneal endothelial injury.Results At one month after the surgery,the UCVA was logMAR(0.49±0.23),and at three months after the surgery,the UCVA was logMAR(0.39±0.17),with a statistically significant difference compared to before the surgery(t=27.60,29.18,P=0.00,0.00).At one month after the surgery,the BCVA was logMAR(0.41±0.18),and at three months after the surgery,the BCVA was logMAR(0.36±0.14),with no statistically significant difference compared to before surgery(t=1.34,1.94,P=0.18,0.05).The CECs was(2515.97±291.40)/mm^(2) before the surgery,and(2377.61±288.50)/mm^(2) one month after the surgery,with a statistically significant difference compared to before the surgery(t=16.01,P=0.00).The CECs at three months after the surgery were(2320.70±287.37)/mm^(2),with a statistically significant difference compared to before the surgery(t=20.24,P=0.00),and with a statistically significant difference compared to one month after the surgery(t=15.79,P=0.00).The coefficient of variation(CV)of cell area was(40.15±2.80)%before the surgery,(42.43±3.25)%at 1 month after the surgery,which was statistically significant compared to before the surgery(t=-15.29,P=0.00),and(44.14±3.40)%at 3 months after the surgery,which was statistically significant compared to before the surgery(t=-21.47,P

关 键 词：无晶状体眼 四点固定 人工晶状体悬吊术 角膜内皮 

分 类 号：R47[医药卫生—护理学]