晶状体超声乳化术前前房空间与术后角膜内皮变化相关性研究

The relationship between anterior chamber space and corneal endothelial change in phacoemulsification.

目的探讨晶状体超声乳化术前前房空间状态与术后角膜内皮细胞变化之间的相关性。方法对19例(20眼)老年性白内障行晶状体超声乳化吸出人工晶状体植入术。术前以OrbscanⅡ测定前房容积、前房深度,使用A超测定眼轴长度,并分别于术前和术后1周使用非接触型角膜内皮显微镜观察中部角膜内皮细胞的密度变化。结果术前的平均前房容积为(158.66±29.14)mm3,前房深度为(2.69±0.41)mm。眼轴长度为(23.79±2.43)mm。术后1周平均中部角膜内皮细胞损失率为31.27%±16.11%;术前的前房容积与术后1周角膜内皮细胞损失率呈显著负相关(r=-0.726,P<0.001),前房深度与术后1周角膜内皮细胞损失率亦呈显著负相关(r=-0.764,P<0.001);术前的眼轴长度与角膜内皮细胞损失率(r=-0.123,P=0.606)之间无相关性。结论晶状体超声乳化人工晶状体植入术后损伤术眼的角膜内皮细胞,术前前房空间状态的测定为临床评估预后提供重要参考。

Objective To study the relationship between anterior chamber space and the corneal endothelial change in phacoemulsification. Methods Phacoemulsification and IOL implantation were performed in 20 eyes of 19 senior patients. The anterior chamber volume and depth were determined quantatively by using Orbscan Ⅱ before surgery. The axial length was examined by A-mode ultrasonography before phaco. Endothelial densities of the mid-cornea were measured with no-ncontaet specular microscope before and one week after surgery. Results The mean preoperative anterior chamber volume was 158.66 ± 29.14mm^3, anterior chamber depth 2.69± 0.41 mm and axial length 23.79 ± 2.43mm. The corneal endothelial cell loss rate was （31.27 ± 16.11% ） . A significant negative correlation existed between the preoperative anterior chamber space and the postoperative corneal endothelial cell loss rate （ P 〈 0.001 ） . There was no statistically significant correlation between the preoperative axial length and the postoperative corneal endothelial cell loss rate （P = 0.606）. Conclusions The measurement of anterior chamber space before phacoemulsification is helpful in evaluating the severity of endothelial damage after surgery and can be used to predict the outcome of the cornea.