青光眼术后行白内障超声乳化吸出术后眼内压和角膜内皮细胞完整性的改变

Intraocular pressure and corneal endothelial cell integrity changes in cataract phacoemulsification after glaucoma surgery

目的评估抗青光眼术后白内障患者行白内障超声乳化吸出术后眼内压和角膜内皮细胞完整性的改变。方法观察60例抗青光眼术后有功能滤泡的白内障患者,在行白内障超声乳化吸出术前及术后1天,3天,1周,1个月眼内压和角膜内皮细胞完整的改变。评估角膜内皮细胞完整性包括评估角膜内皮细胞密度(evaluate endothelial cell density,CD),平均细胞面积(average cell area,AVE),细胞面积变异系数(coefficient of variation of average area,CV)和角膜中心厚度(central corneal thickness,CCT)。结果术后1天、3天及术后1周,眼内压与术前比较差异均具有统计学意义(P<0.05)。术后1个月,为(17.8±2.5)mmHg,差异无统计学意义(P>0.05)。术前及术后1天,3天,1周,1个月观察时间点下,出现内皮细胞密度降低、平均细胞面积增大及面积变异系数增高改变,差异有统计学意义(P<0.05)。术后1天、3天及1周,角膜中心厚度分别为540.1±20.3、550.0±27.9及530.2±18.6,与术前514.4±16.5比较,差异具有统计学意义(P<0.05)。术后1个月,角膜中心厚度为513.0±16.3,与术前比较,差异无统计学意义(P>0.05)。结论抗青光眼术后的白内障患者在行白内障超声乳化吸除术后,眼内压及角膜内皮细胞完整性在术后1天开始变化,在术后1个月基本恢复到术前。

Objective To evaluate intraocular pressure and corneal endothelial cell integrity changes in cataract phacoemulsification after glaucoma surgery. Methods Sixty cases of cata- ract with functional follicles undergoing anti-glaucoma surgery were selected, intraocular pres- sure and corneal endothelial cell integrity changes were observed before and one day, three days, one week, one month after cataract phacoemulsification. The integrity of corneal endo- thelium including corneal endothelial cell density （CD）, average cell area （AVE）, coefficient of variation of average area （CV） and central corneal thickness （CCT） were evaluated. Re- suits After one day,3 days and 1 week, the intraocular pressure increased compared with pre- operation, which had a statistically significant difference （P 〈 0. 05 ）. After 1 month, was （ 17.8 ＋_ 2.5 ） mmHg, with no statistically significant difference （ P 〉 0.05 ）. The endothelialcell density decreased, the average cell size increased and the coefficient of variation increased in preoperative and postoperative one day, three days, one week, and one month observation time point, the differences were statistically significant （P 〈 0. 05 ）. After 1 day, 3 days and 1 week, central corneal thickness were 540. 1 ± 20. 3, 550.0±27.9 and 530. 2± 18.6, versus 514.4 ± 16. 5 before surgery, the differences were statistically significant （P 〈0.05）. After 1 month, central corneal thickness was 513.0 ± 16.3, and the difference was not statistically sig- nificant （P 〉 0. 05 ）. Conclusion In patients with glaucoma after cataract phacoemulsifica- tion, intraocular pressure and endothelial cell integrity change significantly after 1 day, and then return to the preoperative level in a month.,