Nd:YAG激光乳化和超声乳化白内障术后角膜内皮细胞变化的远期观察

Long-term observation of corneal endothelial cells changes after Nd:YAG laser emulsification and phacoemulsification

目的比较Nd:YAG激光乳化和超声乳化白内障摘出术对角膜内皮细胞密度、形态及角膜厚度的影响。方法选取9例(18眼)老年性白内障患者,双眼分别行Nd:YAG激光乳化和超声乳化白内障摘出术联合人工晶状体植入术,术后随访37个月,比较双眼视力、眼压、角膜内皮细胞计数以及角膜厚度等情况。结果术后37个月,Nd:YAG激光乳化眼角膜内皮细胞密度为(1715.4±627.9)mm-2,超声乳化眼角膜内皮细胞密度为(2330.7±426.5)mm-2,2组比较差异具有统计学意义(P<0.05);2组角膜内皮细胞六角形比例、角膜内皮细胞形态变异率和角膜厚度比较,差异均无统计学意义(均为P>0·05)。2组术后视力、眼压差异也均无统计学意义(均为P>0·05)。结论 Nd:YAG激光乳化白内障摘出术后远期角膜内皮细胞数明显减少,应慎重施行激光乳化白内障摘出术。

Objective To compare the long-term effects on density,morphous of corneal endothelial cells and corneal thickness after Nd：YAG laser emulsification and phacoemulsification cataract surgery.Methods Nine senile patients（18 eyes） were performed cataract surgery.In each patient,one eye was performed Nd：YAG laser emulsification whereas the fellow was performed phacoemulsification.The number of corneal endothelial cells,corneal thickness,intraocular pressure and visual acuity were checked.The average follow-up time was 37 months.Results At 37 months after surgery,the average density of corneal endothelial cells in eyes with Nd：YAG laser emulsification and phacoemulsification were（1 715.4±627.9）mm-2 and（2 330.7±426.5）mm-2,respectively,there was statistical difference between two kinds of emulsification（P0.05）.There was no statistical difference in hexagonal corneal endothelial cell rate,aberration rate of corneal endothelial cells morphous,corneal thickness,intraocular pressure and visual acuity between two groups（all P0.05）.Conclusion The number of corneal endothelial cells after Nd：YAG laser emulsification is obviously decreased in the long-term observation,so laser emulsification should be carefully chosen.