CAJ | 학술논문

目的评估白内障超声乳化手术的一些术前以及术中参数对术后角膜内皮损伤的影响.方法 83例患者(100只眼)行白内障超声乳化手术.术前、术中记录患者年龄、核硬度、前房深度(ACD)、眼轴长度、切口累计消散能量(CDE)、注吸时间以及液流量.术前以及术后2周测量患者中央角膜内皮细胞密度(CED)、细胞变异度(CV)、平均细胞面积(AVG)、六边形细胞比率.结果术后2周,角膜内皮细胞平均丢失(377.14 ±283.00) /mm2,丢失率为(14.37±10.59)％,术前、术后内皮细胞密度差异有统计学意义(P ＜0.001).术后角膜内皮形态发生改变,六边形细胞比率减少,术前、术后患者的CV、AVG、六边形细胞比率差别有统计学意义(P ＜0.001).内皮细胞丢失量与核硬度、超声能量、前房深度、年龄有一定的相关性(分别为P ＜0.001,P=0.008,P=0.005,P=0.035),但与液流量、注吸时间、眼轴长度无相关(分别为P =0.420,P=0.607,P=0.823).结论白内障超声乳化手术后内皮细胞损伤的因素是多方面的,例如:核硬度、超声能量、前房深度等.应该提高手术技巧以及手术设备减轻对角膜内皮的损伤.
목적 평고백내장초성유화수술적일사술전이급술중삼수대술후각막내피손상적영향.방법 83례환자(100지안)행백내장초성유화수술.술전、술중기록환자년령、핵경도、전방심도(ACD)、안축장도、절구루계소산능량(CDE)、주흡시간이급액류량.술전이급술후2주측량환자중앙각막내피세포밀도(CED)、세포변이도(CV)、평균세포면적(AVG)、륙변형세포비솔.결과 술후2주,각막내피세포평균주실(377.14 ±283.00) /mm2,주실솔위(14.37±10.59)％,술전、술후내피세포밀도차이유통계학의의(P ＜0.001).술후각막내피형태발생개변,륙변형세포비솔감소,술전、술후환자적CV、AVG、륙변형세포비솔차별유통계학의의(P ＜0.001).내피세포주실량여핵경도、초성능량、전방심도、년령유일정적상관성(분별위P ＜0.001,P=0.008,P=0.005,P=0.035),단여액류량、주흡시간、안축장도무상관(분별위P =0.420,P=0.607,P=0.823).결론 백내장초성유화수술후내피세포손상적인소시다방면적,례여:핵경도、초성능량、전방심도등.응해제고수술기교이급수술설비감경대각막내피적손상.
Objective To evaluate the effect of preoperative and intraoperative parameters on corneal endothelial cell loss after phacoemulsification. Methods Eighty-three patients (100 eyes) scheduled for phacoemulsification were selected for this clinical trial.The main preoperative and intraoperative parameters evaluated were age,density of the nucleus,anterior chember depth (ACD),axial length,cummulative dissipated energy (CDE),irrigation time,and irrigation volume.Before and 2weeks after surgery,the central corneal endothelial cell density (CED),coefficient of variation of cell size (CV),average cell size (AVG) and hexagonality were assessed. Results Two weeks after surgery,the mean corneal endothelial cell lost 377.14 ±283.00 /mm2,with the rate of 14.37±10.59％,and the difference of CED before and after surgery was significant (P ＜0.001).After surgery,the variation of cell size had been obseved with the hexagon cell percentage decreased,and the difference in CV,AVG and hexagonality before and after surgery was significant (P ＜0.001).There were relationships between nuclear density,phaco power,ACD,age and endothelial cell loss (P ＜0.001,P =0.008,P =0.005,P =0.035,respectively); however,total fluid volume,irrigation time and axial length were not significant predictors (P =0.420,P =0.607,P =0.823,respectively). Conclusions Phacoemulsification on corneal endothelial cell loss involves in many factors,such as nuclear density,phaco power and ACD.And the surgical skills and equipments should be improved to reduce the corneal endothelial damage.