超声乳化术与角膜内皮细胞变化的影响因素分析

Relative factors analyses of phacoemulicification on the changes in corneal endothelial cells

目的 :评价超声乳化术中技术参数和患者眼解剖因素对角膜内皮的影响。方法 :前瞻性评价 42例超声乳化及人工晶体植入患者 ,测量眼解剖因素眼轴长、前房深度、晶状体厚度及核分级 ,术中记录超声乳化能量及时间 ,并于术前、术后 3个月、 6个月测量角膜中央区内皮细胞进行分析。结果 :术后 3个月、 6个月角膜中央区内皮细胞平均损失率分别为 10 1%、 12 6% ;并发现对超声乳化术后 3个月和 6个月角膜内皮细胞损伤影响最强的因素均是核分级 ,其次为超声乳化时间 ,即核分级越高或超声乳化时间越长 ,角膜内皮细胞损失越多。浅前房也可能与 3个月时角膜内皮损伤有关 (P =0 0 5 6)。结论 :核分级高及超声乳化时间长是角膜内皮损伤的最危险因素 ,因此提高手术技巧 ,将会缩短超声乳化时间 ,降低角膜内皮损伤。

Objective:To evaluate the influences on corneal endothelial cells of intraoperative parameters of phacoemulcification and eye anatomy. Methods:42 patients who had phacoemulcification were evaluated.Axial length,anterior chamber depth,lens thickness and nucleus firmness were measured.Phacoemulcification time and energy were recored.With a special microscope,central endothelial cells counts were determined preoperatively and 3 and 6 months postoperatively. Results:The mean central endothelial cell loss at 3 and 6 months were 10.1%,12.6%,respectively.The first risk factor found significant for higher central endothelial cell loss was nucleus grade,and the second was phacoemulcification time.Shallow anterior chamber was also relative to endothelial cell loss.There were no significant correlations between central endothelial cell loss and age,sex,axial length,lens thickness and phacoemulcification energy. Conclusions:Both the firmness of the nucleus and longer phacoemulcification time were found as the most significant risk factors for endothelial cell loss.Therefore,improved the phacoemulcification technique lead to shorter phacoemulcification time and less endothelial cell loss.