CAJ | 학술논문

目的：探讨糖尿病患者与非糖尿病患者行玻璃体视网膜手术前后对角膜内皮细胞密度和形态学的影响。 　　方法：收集60例患有糖尿病患者（糖尿病组）和60例非糖尿病患者（对照组），其中30例糖尿病组和30例对照组患者行玻璃体切割联合硅油填充手术，30例糖尿病组和30例对照组患者行晶状体玻璃体切割联合硅油填充手术。检测两组患者术前1 d及术后3 mo角膜内皮细胞密度（ cell densities ， CD ）、内皮细胞面积变异系数（ coefficient of variation ，CV ）、六角形细胞百分比值（ ratio of hexagonal cells ，RHC）。比较两组患者手术前后角膜内皮细胞变化的差异。 　　结果：玻璃体切割联合硅油填充术在糖尿病组与对照组角膜内皮细胞变异系数和六角形细胞百分比手术前后相比差异均有统计学意义，晶状体玻璃体切割联合硅油填充术在糖尿病组和对照组角膜内皮细胞密度、变异系数及六角形细胞百分比手术前后相比差异均有统计学意义；晶状体玻璃体切割联合硅油填充术在糖尿病组手术前后角膜内皮细胞密度、变异系数、六角形细胞百分比的差值与对照组相比差异有统计学意义。 　　结论：玻璃体切割联合硅油填充手术对角膜的影响主要表现在角膜内皮细胞的形态改变；而与非糖尿病患者相比，糖尿病患者行晶状体玻璃体切割联合硅油填充术角膜内皮细胞形态、密度的改变较非糖尿病患者明显，因此术前角膜内皮细胞的严格检查对于糖尿病患者术后视觉的恢复具有重要意义。
목적：탐토당뇨병환자여비당뇨병환자행파리체시망막수술전후대각막내피세포밀도화형태학적영향。 　　방법：수집60례환유당뇨병환자（당뇨병조）화60례비당뇨병환자（대조조），기중30례당뇨병조화30례대조조환자행파리체절할연합규유전충수술，30례당뇨병조화30례대조조환자행정상체파리체절할연합규유전충수술。검측량조환자술전1 d급술후3 mo각막내피세포밀도（ cell densities ， CD ）、내피세포면적변이계수（ coefficient of variation ，CV ）、륙각형세포백분비치（ ratio of hexagonal cells ，RHC）。비교량조환자수술전후각막내피세포변화적차이。 　　결과：파리체절할연합규유전충술재당뇨병조여대조조각막내피세포변이계수화륙각형세포백분비수술전후상비차이균유통계학의의，정상체파리체절할연합규유전충술재당뇨병조화대조조각막내피세포밀도、변이계수급륙각형세포백분비수술전후상비차이균유통계학의의；정상체파리체절할연합규유전충술재당뇨병조수술전후각막내피세포밀도、변이계수、륙각형세포백분비적차치여대조조상비차이유통계학의의。 　　결론：파리체절할연합규유전충수술대각막적영향주요표현재각막내피세포적형태개변；이여비당뇨병환자상비，당뇨병환자행정상체파리체절할연합규유전충술각막내피세포형태、밀도적개변교비당뇨병환자명현，인차술전각막내피세포적엄격검사대우당뇨병환자술후시각적회복구유중요의의。
AIM: To explore the effects of vitreoretinal surgery in diabetics and non -diabetic patients on corneal endothelial cell density and morphology. METHODS: Sixty patients with diabetes ( diabetic group) and 60 non-diabetic patients ( control group ) was collected, of which 30 cases of diabetic group and 30 cases in the control group underwent vitrectomy combined with silicone oil tamponade surgery, 30 cases of diabetic patients and 30 control patients ( lenticular vitreoretinal combined with silicone oil tamponade surgery) .To detect the corneal endothelial cell density ( CD ) , coefficient of variation of endothelial cell area ( CV ) , percentage of hexagonal cells ( RHC ) of two groups of patients 1 day before surgery and three months after surgery. The differences of two groups were compared before and after surgery in corneal endothelial cell changes. RESULTS: After vitrectomy combined with silicone oil surgery, there were significant differences on the coefficient of variation of corneal endothelial cells and the percentage of hexagonal cells between the diabetic and control groups.In the diabetic and control groups, obvious differences were also found in corneal endothelial cell density, coefficient of variation and the percentage of hexagonal cells after lenticular vitreoretinal combined with silicone oil tamponade surgery. The different values for groups of diabetic and non-diabetic all were statistically significant in corneal endothelial cell density, coefficient of variation and the percentage of hexagonal cells before and after surgery. CONCLUSION: The effects of vitrectomy combined with silicone oil tamponade surgery on cornea endothelial cell were mainly reflected on changes of corneal topography.Compared with the non-diabetic group, the changes in corneal endothelial cell shape and destiny of diabetic patients underwent lenticular vitrectomy with silicone oil tamponade surgery are more evidently. Therefore, the strict examination of preoperative corneal endothelial cell has important significant for diabetic patients postoperative visual recovery.