1.8mm同轴微切口超声乳化白内障吸出术对角膜内皮细胞的损伤及修复研究

Effects of 1. 8 mm coaxial micro-incision cataract phacoemulsification on damage and repair of corneal endothelial cells

目的探讨同轴微切口超声乳化白内障吸出术对角膜内皮细胞的损伤及其修复特点。方法选取2011年1月至2013年12月我院收治的100例(100眼)年龄相关性白内障患者为研究对象,根据手术方式不同分为常规切口组和微切口组,分别行常规3.0 mm切口白内障超声乳化术和1.8 mm同轴微切口超声乳化白内障手术,使用角膜内皮显微镜于术前、术后1d、1周、1个月、3个月检查角膜内皮细胞密度和形态,对两组结果进行观察比较。结果两组术前角膜内皮细胞密度组间比较差异无统计学意义(P>0.05);两组术后不同时间角膜内皮细胞密度均低于术前,差异均有统计学意义(均为P<0.05);两组术后不同时间点组间比较,差异均无统计学意义(均为P>0.05)。两组术前六角形细胞比例组间比较,差异无统计学意义(P>0.05);两组术后不同时间六角形细胞比例均低于术前,差异均有统计学意义(均为P<0.05);两组术后不同时间点组间比较,差异均无统计学意义(均为P>0.05)。两组术前角膜内皮细胞变异系数组间比较,差异无统计学意义(P>0.05);两组术后不同时间角膜内皮细胞变异系数均高于术前,差异均有统计学意义(均为P<0.05);两组术后不同时间点组间比较,差异均无统计学意义(均为P>0.05)。两组术后1 d、1周中央角膜厚度增加明显,均高于术前,差异均有统计学意义(均为P<0.05),术后1个月、3个月逐渐恢复至术前水平,与术后1 d、1周比较,差异均有统计学意义(均为P<0.05);两组术前及术后不同时间点中央角膜厚度组间比较差异均无统计学意义(均为P>0.05)。结论同轴微切口白内障超声乳化手术进一步缩小了手术切口,术后恢复更快,是一种安全有效的手术方式。

Objective To discuss the effects of 1.8 mm coaxial micro-incision cataract phacoemulsification on damage and repair of corneal endothelial cells. Meth- ods One hundred patients （ 100 eyes） with age-related cataract in our hospital from January 2011 to December 2013 were chosen, the patients were divided into routine in- cision group and micro-incision group, the 3.0 mm incision phacoemulsification and 1. 8 mm coaxial micro-incision phacoemulsification were performed, respectively. The morphous and density of corneal endothelial cells were observed at pre-operation and postoperative 1 day, 1 week, 1 month, 3 months, and the results were compared. Re- suits There was no statistical difference in the preoperative corneal endothelial cell density between the observation group and control group （P 〉 0.05 ）, the postoperative corneal endothelial cell density at different time of two groups were lower than pre-op- eration （ all P 〈 0. 05 ）, and there was no statistical difference in postoperative corneal endothelial cell density at different time between two groups （ all P 〉 0. 05 ）. There was no statistical difference in the preoperative hexagonal cell rate between two groups （P 〉 0.05 ）, the postoperative hexagonal cell rate at different time of two groups were all lower than pre-operation （ ali P 〈 0.05 ）, no statistical difference was found in the postoperative hexagonal cell rate at different time between two groups （ all P 〉 0.05）. There was no statistical differ- ence in the preoperative variation coefficient of corneal endothelial cell between the observation group and control group （P 〉 0.05 ）, the postoperative variation coefficient of corneal endothelial cell at different time of two groups were higher than pre-operation （ all P 〈 0.05 ）, and there was no statistical difference in postoperative variation coefficient of corneal en- dothelial cell at different time between two groups （ all P 〉 0.05 ）. The central corneal thickness at postoperative 1 day and 1 week increased obviously, which were all higher than pre-operation （ all P 〈 0.05 ）, the postoperative 1 month and 3 months returned to the normal gradually, there were statistical differences compared with the postoperative l day and 1 week （ all P 〈 0.05）. There was no statistical difference in the central corneal thickness at pre-operation and different postoperative time between two groups （ all P 〉 O. 05 ）. Conclusion The 1.8 mm coaxial micro-incision cataract phacoemulsification further shorten the incision, which can achieve the rapid postoperative recovery, is a safe and effective surgical manner for cataract.