老年白内障术后角膜内皮细胞严重丢失情况及影响因素研究

Severe corneal endothelial cell loss after cataract surgery in the elderly and its influencing factors

目的:探讨老年白内障术后角膜内皮细胞严重丢失情况及影响因素。方法:对116例老年白内障患者的临床资料进行回顾性分析,记录患者术前、术后2个月角膜内皮细胞丢失情况,对患者术后角膜内皮细胞严重丢失的影响因素进行分析。结果:患者术后2个月角膜内皮细胞密度(CED)、六角形细胞比例均低于术前(均P<0.05),术后2个月细胞变异度(CV)高于术前(P<0.05);术后2个月116例患者角膜内皮细胞严重丢失发生率52.58%,单因素与多因素分析显示年龄、晶状体Emery硬核分级、超声乳化时间、超声能量、累积释放能量为老年白内障术后角膜内皮细胞严重丢失的独立影响因素(OR值分别为1.640、2.232、2.208、1.887、1.738,95%CI值分别为1.362~6.817、2.089~7.146、1.948~4.889、1.506~3.912、1.304~9.484,均P<0.05)。结论:老年白内障患者术后发生角膜内皮细胞严重丢失风险高,且年龄、晶状体Emery硬核分级、超声乳化时间、超声能量、累积释放能量均是老年白内障术后角膜内皮细胞严重丢失的独立影响因素。

Objective:To investigate the serious loss of corneal endothelial cells after cataract surgery in the elderly and its influencing factors.Methods:The clinical data of 116 elderly cataract patients were retrospectively analyzed.The loss of corneal endothelial cells was recorded before and 2 months after the operation.The factors affecting the severe loss of corneal endothelial cells after the operation were analyzed.Results:The corneal endothelial cell density(CED)and the proportion of hexagonal cells of the patienT2 months after the operation were lower than preoperative(all P<0.05),and the cell variability(CV)of the patient was higher than preoperative(P<0.05).The incidence of severe corneal endothelial cell loss in 116 patients 2 months after surgery was 52.58%.Univariate and multivariate analysis showed that age,crystalline lens Emery hard nucleus grading,phacoemulsification time,ultrasound energy,and cumulative release energy were independent influencing factors for the serious loss of corneal endothelial cells after senile cataract surgery(OR=1.640,2.232,2.208,1.887,1.738,95%CI:1.362-6.817,2.089-7.146,1.948-4.889,1.506-3.912,1.304-9.484,all P<0.05).Conclusion:The risk of severe corneal endothelial cell loss is high in elderly cataract patients after surgery.Age,crystalline lens Emery hard nucleus grading,phacoemulsification time,ultrasound energy,and cumulative released energy are all independent influencing factors for severe corneal endothelial cell loss after senile cataract surgery.