两种不同超声乳化术对兔角膜内皮细胞的影响

The Influence on the Rabbit Corneal Endothelium Cells After two Kinds of Phacoemulsification

目的:探讨冷超声乳化术和热超声乳化术后角膜内皮形态结构的变化。方法:将12只纯种日本大耳白兔随机分为3组,对照组为正常的兔角膜内皮细胞,实验组分为冷超声乳化组和热超声乳化组。每组4只兔,每只兔左眼均行冷超声乳化术,右眼行热超声乳化术。于术前和术后6小时采用接触性角膜内皮显微镜进行角膜内皮细胞形态学定量测定,并在透射电镜下观察角膜内皮细胞超微结构的变化。结果:热超声乳化组细胞密度和六边形细胞百分率明显降低(P<0.01),细胞面积和变异系数明显增加(P<0.01)。角膜中央1mm区域取材的透射电镜切片示冷超声乳化组的内皮损害小于热超声乳化组。结论:在相同的手术条件下,冷超声乳化术后角膜内皮的损伤小于热超声乳化术。

Objective： To investigate the different changes of corneal endothelium cells after two kinds of phacoemulsification （intermittent micropulse phacoemulsification and continuous micropulse phacoemulsification）. Methods. Twelve rabbits were chosen randomly. The compared groups were divided into 2 parts randomly. Each rabbit＇s left eye was performed the intermittent micropulse phacoemulsification, and the right eye with the continuous micropulse phacoemulsification. Tomey EM-100 contact specular microscopy was used to evaluate the morphological indexes of corneal endothelium cells including endothelial cell density, mean cell area, percentage of hexagonal ceils and coefficient of variation preoperatively and 6postoperative hours. At 6 hours after operation, ultrastructural changes of corneal endothelial cells were observed under transmission electron microscope. Results： At 6 hours after operation, endothelial cell density and percentage of hexagonal cells were significantly lower in the continuous micropulse phacoemulsification groupand mean cell area and coefficient of variation were bigger. Under the transmission electron microscope, at 1 mm of central cornea section,the injury degree of corneal endothelium in the intermittent micropulse phacoemulsification groupwas alleviated more significantly than in the continuous micropulse phacoemulsification group. Confusion： Under the same operation condition, the damage caused by the intermittent micropulse phacoemulsification.