白内障摘出联合前段玻璃体切割对儿童白内障角膜散光和内皮细胞的影响

Effects of cataract extraction combined with vitrectomy on corneal astigmatism and endothelial cells in children cataract

目的观察白内障摘出联合前段玻璃体切割对儿童白内障角膜散光和内皮细胞的影响。方法选取2012年8月至2014年4月我院收治的儿童白内障患者60例(120眼)为研究对象,按照手术方式的不同,分为观察组、对照组各30例(60眼),对照组行单纯白内障摘出,观察组在对照组治疗基础上联合前段玻璃体切割,观察比较两组患儿术前及术后1个月角膜散光的变化,并行角膜内皮细胞计数,观察记录角膜内皮细胞数量的变化,同时比较两组术后后发性白内障发生率差异。结果两组手术前后角膜散光情况组内及组间比较,差异均无统计学意义(均为P>0.05)。两组术后角膜内皮细胞数量均低于术前,差异均有统计学意义(均为P<0.05);两组手术前后角膜内皮细胞数量组间比较,差异均无统计学意义(均为P>0.05);观察组、对照组术后角膜内皮细胞丢失数量分别为(199.8±29.4)mm-2、(203.4±28.3)mm-2,差异无统计学意义(P>0.05)。观察组术后后发性白内障发生率为5.0%,对照组为26.7%,差异有统计学意义(χ2=10.568,P<0.05)。结论儿童白内障行白内障摘出联合前段玻璃体切割对角膜内皮细胞及角膜散光的影响不大,且能明显降低术后后发性白内障的发生率。

Objective To observe the effects of cataract extraction combined with vitrectomy on corneal astigmatism and endothelial cells in children cataract. Methods A total of 50 children （ 120 eyes） with cataract from August 2012 to April 2014 were chosen as the research subject, according to the different surgical methods the children were divided into observation group and control group,30 cases （60 eyes） in each group. The control group was given simple cataract extraction, and the observa- tion group with cataract extraction combined with anterior vitrectomy. The corneal a- stigmatism at pre-operation and postoperative 1 month in two groups were compared, the corneal endothelial cell counts was performed to calculate the endothelial cell num- ber, and the incidence of posterior capsule opacification between two groups was com- pared. Results There was no statistical difference in preoperative and postoperative corneal astigmatism between two groups （ all P 〉 0.05 ）. The postoperative corneal en- dothelial cells in two groups were all less than pre-operation （ all P 〈 0.05 ）. There was no statistical difference in preoperative and postoperative corneal endothelial cells be- tween two groups （ all P 〉 0.05 ）. The postoperative corneal endothelial cell loss number in observation and control groups were （ 199.8 ± 29.4） mm -2 and （ 203.4 ± 28.3 ） mm 2, respectively, there was no statistical difference （P 〉 0.05 ）. The incidence of posterior capsule opacification in observation and control groups were 5.0% and 25.7% , respectively,there was statistical difference （X2 = 10. 558,P 〈 0.05 ）. Conclusion Cataract extraction combined with vitrectomy for children cataract has no obvious effect on corneal astigmatism and endothelial cells, but can effectively reduce the incidence of posterior capsule opacification.