白内障摘除并人工晶体植入术后早期角膜水肿的临床分析

Clinical Analysis of Corneal Edema Occurring in the Early Stage after Cataract Surgery

目的：探讨白内障摘除并人工晶体植入术后早期角膜水肿的部分相关因素。方法：通过分析1010例1043眼白内障摘除并人工晶体植入术后早期角膜水肿的情况,研究糖尿病、晶体材质、肝素处理、粘弹剂、超声乳化白内障吸出术、年龄和性别与角膜水肿的关系。结果：早期角膜水肿204眼,发生率为19.6%。多元Logisitc回归分析发现晶状体材料为PMMA、材料为亲水性丙烯酸酯、肝素处理、混合粘弹剂是术后早期角膜水肿的影响因素,其OR值分别为3.995（2.106-7.579）、3.12（1.827-5.326）、2.131（1.052-4.317）、0.21（0.044-0.992）。结论：晶状体材料为PMMA、肝素处理过的晶体能显著增加术后角膜水肿的风险,材料为亲水性丙烯酸酯较非亲水性丙烯酸酯材料发生角膜水肿发生风险增加,混合粘弹剂降低发生角膜水肿的风险。糖尿病、年龄及性别与角膜水肿无关。

To find the factors related to the corneal edema occurred in the early stage after cataract surgery, 1010 cases （1043 eyes） were investigated and analyzed after undergoing cataract surgery. The influence of diabetes mellitus（DM）, materials of the lens, heparin treatment, viscoelasticity, Phacoemulsification, age and gender upon the rote of corneal edema was researched. It is found that 204 eyes occurred corneal edema in the early stage（19.6%）. Multivariate Logisitc regression analysis revealed that PMMA, hydrophilic acrylic material, heparin treatment, mixed viscoelastic agents are the key factors of early postoperative corneal edema. The odds ratio （OR） values are 3.995（2.106-7.579）, 3.12（1.827-5.326）, 2.131（1.052-4.317）, 0,21（0.044-0.992）, respectively. The lens made by PMMA or heparin-modified lens can increase the risk of corneal edema after operation. The eyes with hydrophilic acrylic lens occurs corneal edema more than those with the hydrophobie acrylic lens. Mixed viscoelastic materials decrease the risk of corneal edema. DM, age and gender do not lead to corneal edema in the early stage after opration.