白内障超声乳化术对不同病程糖尿病患者角膜内皮细胞的影响

Phacoemulsification on corneal endothelium cells in diabetic patients with different disease duration

目的:观察不同病程糖尿病患者白内障超声乳化手术后角膜内皮细胞的变化规律,探讨糖尿病及其病程长短对术后角膜内皮细胞的影响。方法:随机选取患有糖尿病的白内障患者97例135眼,根据病程长短分为Ⅰ组(糖尿病病程≥10a)和Ⅱ组(糖尿病病程<10a),另随机选取年龄相关性白内障患者62例89眼作为对照组,分别测量三组患者术前及术后角膜内皮细胞密度、六边形细胞比例、变异系数,对测量结果进行统计学分析。结果:三组患者术后角膜内皮细胞密度和六边形细胞比例与术前相比均呈下降趋势,角膜内皮细胞变异系数在术后1wk;1mo与术前相比呈增大趋势,差异有统计学意义(P<0.05);两糖尿病组术后角膜内皮细胞密度及六边形细胞比例均低于对照组,角膜内皮细胞变异系数均大于对照组,差异有统计学意义(P<0.05);两组糖尿病组之间术前角膜内皮细胞密度、六边形细胞比例及内皮细胞变异系数无显著性差异(P>0.05),而术后Ⅰ组六边形细胞比例低于Ⅱ组,内皮细胞变异系数高于Ⅱ组,差异有统计学意义(P<0.05)。结论:白内障超声乳化手术对角膜内皮有一定损伤,由于糖尿病对角膜内皮细胞形态及功能的影响与病程长短有关,手术对糖尿病患者角膜内皮损伤更明显,糖尿病病程越长,手术中角膜内皮越易受损。

AIM：To observed the variation regularity of corneal endothelial cells in patients with different diabetes duration after phacoemulsification, and investigate the effects of diabetes and its disease duration on corneal endothelial cells. METHODS： Ninety-seven （ 135 eyes ） cataract patients with diabetes were selected randomly and divided into GroupⅠ（ which diabetes duration ≥10a） and GroupII（which diabetes duration 〈10a） according to their disease duration. Additionally 62 （89 eyes） age-related cataract patients were randomly selected as the control group. The corneal endothelial cell density （ CD ） , proportion of hexagonal cell and coefficient of variation （ CV ） in the three group patients were measured respectively before phacoemulsification and after surgery. And the measurement results were statistically analyzed. RESULTS：The corneal endothelial CD and proportion of hexagonal cell in the three group were decreased after surgery compared with preoperative. But the CV of corneal endothelial cells was increased on the 1 st wk and in 1st mo after surgery compared with the preoperative. The difference was statistically significant （P〈0. 05）. The corneal endothelial CD and proportion of hexagonal cell in the two diabetic groups were lower than the control group after surgery. However, the CV of corneal endothelial cells was higher than the control group. The difference was statistically significant （ P 〈 0.05 ） . There was no significant difference in the corneal endothelial CD, proportion of hexagonal cell and CV between the two diabetic groups before phacoemulsification （P〉0. 05）. The proportion of hexagonal cell in Group Ⅰ was lower than which in GroupIIafter surgery. While the CV was higher than which in Group II. The difference was statistically significant （P〈0. 05）. CONCLUSION： Phacoemulsification has some damage on the corneal endothelial. Since the impact of diabetes on the morphology and function of corneal endothelial cell was related to the diabetic duration. So phacoemulsification has more obvious damage on the corneal endothelial in diabetic patients. And the diabetic duration was longer, the damage on the corneal endothelial in phacoemulsification was more easily.