激光与超声乳化白内障术后角膜内皮及眼压变化分析

Corneal changes in of Er:YAG laser emulsification and phacoemulsification for cataract surgery

目的比较激光乳化白内障吸除术与超声乳化白内障吸除术对角膜内皮形态、密度及角膜厚度的影响,及手术前后眼压的变化。方法对30例(32只眼)白内障病人行激光乳化及后房型人工晶体植入术,同期进行30例(35只眼)超声乳化及后房型人工晶体植入术,对术眼手术前后角膜内皮细胞损失率、六边形细胞百分率、角膜厚度以及眼压的变化进行比较。结果激光组术后1周、1个月及3个月角膜内皮损失率分别为7.56%、5.26%及5.12%,均明显小于超声组的10.31%、11.04%及8.37%;激光组六边形细胞百分率分别为52.49%、53.28%及53.60%,均明显大于超声组的45.30%、46.61%及46.63%;角膜厚度增加率激光组为11.26%、4.91%及2.45%,与超声组的12.69%、5.69%及2.92%相比无统计学差别,眼压手术后2小时及20小时与术前比有统计学差异,但两组术后3天、1周、1个月及3个月的眼压与术前比无统计学差异,两组之间术前及术后各时间点相比无统计学差异。结论激光乳化术较超声乳化术对角膜内皮损伤更小,安全性更高。

Objective To compare the effects to cornea of Er：YAG laser emulsification and phacoemulsification for cataract surgery. Methods Er：YAG laser was performed on 32 eyes,phacoemulsifica- tion was performed on 35 eyes and both were with senile cataract. The loss rate of cornea endothelium, the rates of hexagonal cell and corneal thickness were compared. Results The rates of lost corneal endothelium at post-operative 1 week, 1 month and 3 month in laser emulsification surgery group were 7.56%, 5.26% and 5.12%, respectively;and those in phaco group were 10.31%, 11.04% and 8.37%, respectively. The rates of hexagonal cell after operations in laser group were 52. 49%, 53. 28% and 53.60%, and those in phaco group were 45.30%, 46.61% and 46.63% ,respectively. The difference of the corneal thickness in the two groups was no statistic significance. There were no obvious differences between the two groups before and after operation, but the lOP changed after operation 2 hours and 20 hours. Conclusions For cataract extraction, Er： YAG laser emulsification may be safer than that of phacoemulsification.