超声乳化术对高度近视白内障患者角膜内皮细胞的影响

Effect of phacoemulsification on corneal endothelial cells in patients with high myopia cataract

目的研究超声乳化术对高度近视白内障患者角膜内皮细胞的影响。方法选取2020年4月至2022年3月于上饶市人民医院行白内障手术患者26例30眼,根据患者是否有高度近视,将其分为高度近视组(14例,15眼)和对照组(12例,15眼)。两组患者均行超声乳化+人工晶体植入术,比较两组患者手术前后角膜内皮细胞密度(endothelial cell density,CD)、平均角膜内皮细胞面积(average endothelial cell size,AVG)、变异系数(coefficient of variation,CV)、六角形细胞比例(percentage of hexagonal cell,HEX)。结果术前,两组患者的CD、AVG比较差异均无统计学意义(P>0.05),高度近视组患者的CV显著大于对照组,HEX显著小于对照组(P<0.05)。术后1周、1个月、3个月,两组患者的CD、HEX均显著小于本组术前,AVG、CV均显著大于本组术前(P<0.05);高度近视组患者的CD、HEX均显著小于对照组,AVG、CV均显著大于对照组(P<0.05)。结论高度近视白内障患者的角膜内皮细胞稳定性、耐受性差,更易受手术影响及损伤,术前评估其功能及术中注意保护是减少术后角膜内皮相关并发症、提高手术质量的关键。

Objective To study the effect of phacoemulsification on corneal endothelial cells in patients with high myopia cataract.Methods A total of 26 patients with 30 eyes who underwent cataract surgery in Shangrao People’s Hospital from April 2020 to March 2022 were selected.According to whether the patients had high myopia,they were divided into high myopia group(14 cases,15 eyes)and control group(12 cases,15 eyes).Both groups underwent phacoemulsification and intraocular lens implantation.Corneal endothelial cell density(CD),average endothelial cell size(AVG),coefficient of variation(CV),percentage of hexagonal cell(HEX)before and after surgery were compared between the two groups.Results Before surgery,there were no significant difference in CD and AVG between the two groups(P>0.05).CV in high myopia group was significantly higher than that in control group,HEX was significantly lower than that in control group(P<0.05).At 1 week,1 month and 3 months after surgery,CD and HEX in two groups were significantly lower than before surgery,AVG and CV were significantly higher than before surgery(P<0.05).CD and HEX in high myopia group were significantly lower than those in control group,and AVG and CV were significantly higher than those in control group(P<0.05).Conclusion The stability and tolerance of corneal endothelial cells in highly myopic cataract patients are poor,and they are more susceptible to surgical impact and injury.Preoperative evaluation of their function and intraoperative protection are the key to reduce postoperative corneal endothelial-related complications and improve the quality of surgery.