穿透性及非穿透性小梁手术对开角型青光眼角膜内皮的影响

Effects of different surgeries on the corneal endothelium with primary open angle glaucoma.

目的对比小梁切除术与非穿透性深层巩膜切除术对青光眼角膜内皮的影响。方法回顾性分析术后的原发性开角型青光眼56例74眼,包括小梁切除术和非穿透性深层巩膜切除术各28例37眼,对术前术后的角膜内皮细胞密度、中心角膜厚度及正常形态角膜内皮细胞的比例进行了测定,计算其变化并进行t检验及2χ检验。结果(1)小梁切除术组术前术后的比较:角膜内皮细胞数目差异有统计学意义;中心角膜厚度和正常形态角膜内皮细胞的比例差异无统计学意义。(2)非穿透性深层巩膜切除术组术前术后的比较:三项差异均无统计学意义。(3)小梁切除术组与非穿透性深层巩膜切除术组术前术后各项值变化率的比较:角膜内皮细胞数目和正常形态角膜内皮细胞的比例的变化率差异有统计学意义;中心角膜厚度变化率差异无统计学意义。结论小梁切除术与非穿透性深层巩膜切除术相比,后者对角膜内皮损伤较小。

Objective To study the corneal endothelium in patients with primary open angle glaucoma who accept trabeculectomy as compared to nonpenetrating trabecular surgery and investigate effects ofdifferent surgeries on the corneal endothelium with primary open angle glaucoma.Methods Corneal endothelium cell density,central corneal thickness and percentage of hexagonal cells were measured in aseries of primary open angle glaucoma patients：28 cases accept trabeculectomy,28 cases accept nonpenetrating trabecular surgery,all data were analyzed statistically with t-test and χ2 test. Results （1） Trabeculectomy group： Compared with pre-operation,corneal endotheliumcell density showed high significant differences（P〈0.01）,central corneal thickness and percentage of hexagonal cells showed no significant differences（P〉0.05）.（2）Nonpenetrating trabecular surgery group＇Compared with pre-operation,both of them showed no significant differences（P〉0.05）（3） Change rate oftwo groups： The change rate of corneal endothelium cell density and percentage of hexagonal cells showed high significant differences（P〈0.01） between trabeculecto-my group and nonpenetrating trabecular surgery group,central corneal thickness showed no silgnificant differences（P〉0.05）. Conclusions Compared with trabeculectomy,nonpenetrating trabecular surgery has less effect on the corneal endothelium with primary open angle glaucoma.