白内障超声乳化吸除术中灌注水流方向对角膜内皮的影响

Effect of perfusion flow direction on corneal endothelium in phacoemulsification for cataract

目的观察白内障超声乳化吸除术中灌注水流的方向改变对角膜内皮的影响,寻找减少术后角膜水肿发生的方法。方法将我院2015-01-2015-05的80例白内障患者依据术中灌注水流方向不同分为A组和B组。A组：术中灌注水流方向与虹膜平面夹角〈45°;B组：术中持续或多次出现灌注水流方向与虹膜平面夹角≥45°。观察术前和术后两组角膜内皮的密度变化,比较两组术后角膜水肿的发生率。结果 A组的术后角膜内皮平均密度高于B组（P〈0.01）;A组的术后角膜水肿的发生率低于B组（P〈0.01）。结论术中超声及注吸探头两侧灌注水流的方向与虹膜平面的夹角应尽量减小,可以有效减少灌注水流对角膜内皮的冲刷,从而减少术后角膜内皮的损伤,降低术后角膜水肿的发生率。

Objective To explore the effect of perfusion flow direction on corneal endothelium in the process of phacoemulsification,and to search for a method for reducing the occurrence of corneal edema. Methods From January 2015 to May 2015,80 patients with cataract were divided into group A and group B according to the different perfusion flow direction. The angle between the perfusion flow direction and the iris plane was less than 45° in group A,while the angle was more than 45° in group B. The density of corneal endothelium cells in the two groups were observed before and after operation. The incidence of corneal edema after the operation was compared between two groups. Results The average density of corneal endothelium in group A was significantly higher than that in group B（ P〈0. 01）. The incidence of corneal edema in group A was significantly lower than that in group B（ P〈 0. 01）. Conclusion During the operation,the decrease of angle between the perfusion flow direction and the iris plane can effectively reduce the scour of the perfusion flow to corneal endothelium,and then reduce the corneal endothelial damage and the incidence of corneal edema after operation.