不同手术方式在白内障患者中的效果及对角膜内皮细胞的影响研究

Study on the Effect of Different Operation Methods in the Patients with Cataract and Influence on Corneal Endothelial Cells

目的:观察及比较不同手术方式在白内障患者中的效果及对角膜内皮细胞的影响。方法:选取2018年9月-2020年10月新疆生产建设兵团第十三师哈密红星医院的100例采用超声乳化手术治疗的白内障患者为研究对象,将其随机分为对照组和观察组,每组50例。对照组进行常规切口治疗,观察组进行微切口治疗。比较两组术后不同时间的手术源性散光度、手术前后的裸眼视力及最佳矫正视力、角膜内皮细胞相关指标(角膜内皮细胞密度及平均细胞面积、六角形细胞比例及变异系数)。结果:观察组术后不同时间的手术源性散光度均显著优于对照组,差异均有统计学意义(P<0.05);两组间手术前后的裸眼视力及最佳矫正视力比较,差异均无统计学意义(P>0.05);术前,两组角膜内皮细胞密度及平均细胞面积、六角形细胞比例及变异系数比较,差异均无统计学意义(P>0.05),观察组术后不同时间的角膜内皮细胞密度及平均细胞面积、六角形细胞比例及变异系数均显著优于对照组,差异均有统计学意义(P<0.05)。结论:微切口在白内障患者中的效果较好,且对角膜内皮细胞的不良影响相对更小,因此在白内障患者中的应用价值相对较高。

Objective:To observe and compare the effect of different operation methods in the patients with cataract and influence on corneal endothelial cells.Method:A total of 100 patients with cataract treated with phacoemulsification in Hami Red Star Hospital of 13th Division of Xinjiang Production and Construction Corps from September 2018 to October 2020 were chosen as the research objects,and they were randomly divided into control group and observation group,with 50 cases in each group.The control group was treated with conventional incision and the observation group was treated with micro incision.Then the surgical astigmatism at different time after the operation,uncorrected visual acuity and best corrected visual acuity,corneal endothelial cell related indexes (corneal endothelial cell density and average cell area,hexagonal cell proportion and coefficient of variation) before and after the treatment of two groups were compared.Result:The surgical astigmatism of observation group at different time after the operation were all significantly better than those of control group,there were statistically significant differences (P<0.05);the uncorrected visual acuity and best corrected visual acuity of two groups before and after the operation were compared,there were no statistically significant differences (P>0.05);there were no significant differences in corneal endothelial cell density,average cell area,hexagonal cell proportion and coefficient of variation between the two groups before operation (P>0.05).The corneal endothelial cell density,average cell area,hexagonal cell proportion and coefficient of variation in the observation group at different times after operation were significantly better than those in the control group (P<0.05).Conclusion:The effect of microincision in the patients with cataract is better,and its bad influence on corneal endothelial cells is relatively smaller,so its application value in the patients with cataract is relatively higher.