环形撕囊直径对小切口非超声乳化白内障囊外摘除术的影响

Impact of continuous curvilinear capsulorhexis diameter on corneal endothelial cells following small-incision extracapsular cataract extraction surgery

目的：观察小切口白内障囊外摘除术中连续环形撕囊直径的大小对角膜内皮细胞的影响。方法：选择2014年4~12月行小切口白内障手术患者45例45眼,分为A组（连续环形撕囊直径〉6 mm）和B组（连续环形撕囊直径〈5.5 mm）。观察两组患者手术前后角膜内皮细胞密度、视力变化及术后角膜水肿情况。结果：两组患者术后7 d、1月、3月角膜内皮细胞密度较术前均下降（P〈0.01）;两组患者术后1月、3月的视力均较术后7 d有所提高（P〈0.01）;A组术后无角膜混浊、水肿的病人人数高于B组,差异有统计学意义（P〈0.01）。结论：小切口白内障囊外摘除术中连续环形撕囊直径较大对角膜内皮细胞损伤较轻,术后视力恢复较快,术后角膜水肿发生率较低。

Objective： To observe the impact of diameter of continuous curvilinear capsulorhexis on corneal endothelial cells in patients following small-incision extracapsular cataract extraction surgery.Methods： Forty-five age-related cataract cases（ 45 eyes）,received small-incision extracapsular cataract contraction in our department between April and December of 2014,were divided into group A（ continuous curvilinear capsulorhexis being greater than 6 mm in diameter） and group B（ continuous circular capsulorhexis being greater than 5.5 mm in diameter）.The two groups were compared regarding the pre-and post-operative changes of corneal endothelial cell density as well as visual acuity and corneal edema following operation. Results： The density of corneal endothelial cells was reduced in both groups in day 7,the first and the third month after surgery（ P〈0.01）.Visual acuity was improved in the first and the third month as compared to the condition observed at day 7 after operation in both groups（ P〈 0.01）,however,group A had lower rate of corneal opacity and corneal edema than that of group B（ P〈0.01）.Conclusion： Relative larger diameter of continuous curvilinear capsulorhexis in small-incision extracapsular cataract extraction may lead to less damage to corneal endothelial cells,rapid recovery of visual acuity and less postoperative corneal edema.