两种不同白内障术式对角膜内皮细胞的影响

Influence of two types of cataract surgery on corneal endothelial cells

目的:观察两种不同白内障手术方式对角膜内皮细胞的影响。方法:选择2011-03/10在我院眼科行白内障手术的年龄相关性白内障患者82例82眼,随机分为超声乳化手术组(A组)与小切口白内障囊外摘除手术组(B组)。观察两组在手术前后不同阶段的角膜内皮细胞变化及术后角膜水肿情况。结果:(1)术后7d时两组角膜内皮细胞平均密度均较术前降低(P<0.05),数值随时间略有增长,但至术后3mo时仍低于相应术前水平(P<0.05);术后7d;1,3mo时角膜内皮细胞平均密度A组明显高于B组(P<0.05);(2)两组术后7d;1,3mo的六角形细胞比例均值较各组术前低,组间存在差异(P<0.05);(3)术后角膜水肿情况A组较B组轻(P<0.05)。结论:超声乳化手术相对小切口白内障囊外摘除手术对于角膜内皮的损伤要轻,术后角膜水肿发生率要低。

AIM： To compare the effects of small incision extracapsular cataract extraction and phacoemulsification on corneal endothelial cells. ~ METHODS： Eighty-two age-related cataract cases （82 eyes） from March 2011 to October 2011, were randomly divided into two groups： phacoemulsification group （~ group A） and small incision extracapsular cataract extraction group （group B ）. Corneal edema after operation and changes in corneal endothelial cells in different stages before and after operation were observed. ~ RESULTS： In both groups, there was significant difference in the data of corneal endothelial cell density before and after operation （ P〈O. 05）. Although all the postoperative data of corneal endothelial cell density were lower than the preoperative ones, they had been slightly increasing over time. The mean density of corneal endothelial cell in group A was significantly higher than that in group B at 7d, 1 month and 3 months after operation （P 〈 0. 05 ）. In both groups, the average proportion of corneal hexagonal cells at 7d, 1 month and 3 months after operation was obviously lower than that before surgery, with significant difference between the two groups. Postoperative corneal edema was less severe in group Athan in group B （P〈0.05）. CONCLUSION： Phacoemulsification causes less damage to corneal endothelial cells and less postoperative corneal dema than small incision extracapsular cataract xtraction