中医参与治疗白内障术后角膜水肿的研究

Study of the causes of corneal edema after cataract surgery and the effects of traditional Chinese medicine intervention

要目的：分析超声乳化白内障术后角膜水肿的相关因素，探讨其防治原则以及中医参与治疗的作用。方法：通过观察650例689眼超声乳化白内障术后第1天发生角膜水肿的情况，分析角膜水肿与年龄、核硬度、合并症的关系。结果：本组白内障患者650例689眼，超声乳化白内障及人工晶体植入术后1天发现2级以上角膜水肿180例180眼，角膜水肿总发生率为26．12％。45~59岁、60~69岁、70~79岁、80＂06岁的患者术后角膜水肿发生率分别为10．3％、19．6％、31．7％、75％；Ⅱ级、Ⅲ级、Ⅳ级、V级核的患者术后角膜水肿发生率分别为7．4％、19．4％、40．3％、100％；青光眼减压术后、陈旧性葡萄膜炎、糖尿病合并白内障的患者术后角膜水肿发生率（46．7％、45．8％、35．3％）较无合并症的年龄相关性白内障患者（19．6％）均明显增加。结论：超声乳化白内障术后角膜水肿发生率与患者年龄、晶体核的硬度、合并症等成正相关；术后常规用药加活血利水、明目退翳中药治疗能缩短角膜水肿消退时间，提高临床疗效。

Objective： To analyze the related factors of corneal edema after phacoemulsification cataract surgery, and to explore the effect of traditional Chinese medicine intervention. Methods： Conditions of corneal edema of 689 eyes of 650 cases on the first day after phacoemulsification cataract surgery were observed, and the relationships between corneal edema and age, lens nuclear hardness, and complications were analyzed. Results： Among 650 of patient＇s 689 eyes, the edemas were found worse than grade 2 in 180 eyes of 180 cases（26.12%） on the 1st day ater phacoemulsification and intraocular lens implantation. The rate of postoperative corneal edema in 45-59, 60~69, 70~79, and 80~96 years old patients was 10.3%, 19.6%, 31.7% and 75.0% respectively;In patients with lens nuclear hardness of Class Ⅱ, Ⅲ, IV, V, the rate of postoperative corneal edema was 7.4%, 19.4%, 40.3%, and 100% respectively. In glaucoma after decompression, chronic uveitis, and diabetic cataract patients, postoperative corneal edema rate （46.7% ,45.8% ,35.3% ）was higher than in patients with age-related cataract （19.6%）. Conclusion： The incidence of corneal edema after phacoemulsification is positively correlated with the age of patients, lens nucleus hardness, and complications.The treating course can be shortened and the clinical efficacy can be improved if treating corneal edema by postoperative routine medication plus Chinese herbs,which can remove the blood stasis and promote diuresis, as well as improve the sight and remove the nebu- la.