超声乳化对小梁切除术后白内障患者角膜内皮细胞的影响

Corneal endothelial cell changes after phacoemulsification in patients with trabeculectomy

目的探讨白内障超声乳化术对小梁切除术后的白内障患者角膜内皮细胞的影响。方法选取30例曾行小梁切除术的白内障患者为研究组,另选取30例年龄相关性白内障患者作为对照组。分别在术前、术后3个月检测两组患者的角膜内皮细胞密度,角膜内皮细胞大小变异系数,六边形细胞百分比。并应用SPSS统计软件进行统计学分析。结果术后3个2 2月研究组的角膜内皮细胞密度减少265.81个/㎜(11.4%),对照组减少72.88个/㎜(4.3%),两组之间差异具有统计学意义(P=0.000),六边形细胞百分比较对照组低,且差异具有统计学意义。两组患者的细胞变异系数之间无差异。结论白内障超声乳化联合人工晶体植入术后3个月,小梁切除术后的白内障患者角膜内皮细胞损失较正常年龄相关性白内障患者严重,且恢复慢。因此术前应行角膜内皮细胞检查,严格掌握手术适应症;术中注意操作技巧,减少对角膜内皮的损伤。

Objetive To investigate the change of the corneal endothelial cells in patients who had undergone trabeculectomy before and after phacoemulsification. Methods A clinical prospective study including 30 patients with cataract for research group who had undergone trabeculectomy and 30 patients for control who hadnot undergone trabeculectomy. The corneal endothelial cell density, variation in endothelial cell size（CV） and percentage of hexagonal cells were recorded at baseline and at 3 months postoperatively. Results The mean decrease in endothelial cell density at 3 months in the resarch group was 265.81 cells per square millimeter（11.4%） and 72.88 ceils persquare millimeter（4.3%） in the control group. The difference in cell loss between the 2 groups was significant（P=0.000）. A significant decrease in the percentage of hexagonal cells was seen in the experimental group. There was no statistically significant change in CV. Conclusions A significant greater loss of corneal endothelial cells and slowly repair process in the group had ac, eepted trabeculectomy,compared with group that had not undergone trabeculectoray 3 months after phacoemulsification. For the patients who had accepted trabeculectomy, the examination of corneal endothelial cells is necessary. Meanwhile decreasing the damage of endothelial cells should been obtained by improving operative skills.