青光眼白内障三联手术对角膜内皮细胞的影响

Effect of ultrasonic emulsification triple surgery for glaucoma complicated with cataract on corneal endothelial cells

目的:分别观察采用小切口白内障囊外摘除联合小梁切除及后房型IOL植入术和白内障超声乳化吸出联合小梁切除及后房型IOL植入术治疗白内障合并青光眼对角膜内皮细胞的影响。方法:应用非接触式角膜内皮显微镜对白内障超声乳化术(n=14)和小切口白内障囊外摘除术(n=21)2组病例的术前和术后3mo的角膜内皮细胞密度和面积等进行观察。结果:超声组与小切口术后3mo的角膜内皮细胞损失率比较经统计学分析其差异无显著性意义(P>0.05)。结论:白内障超声乳化吸出联合小梁切除及后房型IOL植入术治疗青光眼合并白内障是一种安全有效的手术方法。

AIM： To observe the changes of corneal endothelial cells after trlple-surgery of trabeculetomy, ultrasonic phacoemulsificatJon and posterior chamber intraocular lens （IOL） implantation, or small incision non-ultraemulsification IOL implantation for cataract combined with glaucoma.METHODS： The denslty and area of corneal endothelium cells in the phacoemulsiflcatlon group and the control group with small Inclsion extracapsular extraction of glaucoma and complicated cataract were measured by specular microscope before surgery and 3 months after surgery.RESULTS： In phacoemulsification group, the rate of the corneal endothelial cells loss was 10.79%± 3.69%. In small incision non-ultraemulsification group, the rate of the corneal endothelial cells loss was 12.56% ± 3.03%. The levels of postoperative cell density and average area are significantly different from those of the preoperative. There was no significant difference in the control group （P 〉 0.05）.CONCLUSION： The triple procedure of phacoemulsification, intraocular lens implantation combined with trabeculectomy is safe and effective for treating coexisting glaucoma and cataract, and it can reduce intraocular pressure, improve visual acuity rapidly with few post-operative complications.