CAJ | 학술논문

目的：评价超声乳化吸除术在治疗低密度角膜内皮细胞白内障患者的可行性和手术效果。方法对10例（12只眼）角膜内皮细胞密度＜1500个/mm2的白内障患者行白内障超声乳化吸除人工晶状体植入术。其中Fuchs角膜营养不良3只眼，抗青光眼术后4只眼，颗粒状角膜营养不良2只眼，穿透性角膜移植术后3只眼。使用角膜内皮显微镜检查所有患者术前术后角膜内皮细胞密度，并观察术后视力及角膜水肿变化。结果所有患者术后视力均有不同程度提高，术后3个月最佳矫正视力0．1～0．4者8只眼，≥0．5者4只眼。术后角膜水肿为轻中度，常于术后5～7 d恢复，无角膜内皮细胞失代偿。内皮细胞损失率8．83％。结论低密度角膜内皮细胞白内障患者在一定程度上可行白内障超声乳化联合人工晶状体植入术。严格掌握手术适应证、术中注意保护角膜内皮细胞和由经验丰富的术者完成手术是疗效满意的重要保证。
목적：평개초성유화흡제술재치료저밀도각막내피세포백내장환자적가행성화수술효과。방법대10례（12지안）각막내피세포밀도＜1500개/mm2적백내장환자행백내장초성유화흡제인공정상체식입술。기중Fuchs각막영양불량3지안，항청광안술후4지안，과립상각막영양불량2지안，천투성각막이식술후3지안。사용각막내피현미경검사소유환자술전술후각막내피세포밀도，병관찰술후시력급각막수종변화。결과소유환자술후시력균유불동정도제고，술후3개월최가교정시력0．1～0．4자8지안，≥0．5자4지안。술후각막수종위경중도，상우술후5～7 d회복，무각막내피세포실대상。내피세포손실솔8．83％。결론저밀도각막내피세포백내장환자재일정정도상가행백내장초성유화연합인공정상체식입술。엄격장악수술괄응증、술중주의보호각막내피세포화유경험봉부적술자완성수술시료효만의적중요보증。
Objective To evaluate the feasibility and clinical outcomes of phacoemulsification in cataract patients with low endothelial cell density .Methods A total of 10 cataract patients (12 eyes) with low corneal endothelial cell den-sity (<1500/mm2 ) underwent phacoemulsification and intraocular lens ( IOL ) implantation .Pre-existing conditions of these operated eyes included Fuchs corneal dystrophy ( n =3), granular corneal dystrophy ( n =2), post-anti-glaucoma surgery ( n =4), and post-penetrating keratoplasty ( n =3).We used corneal endothelium counter (Tomey EM-3000) to measure corneal endothelial cell counts before and after cataract surgery .Visual acuity and corneal edema were also investi-gated.Results Visual acuity improved in all patients at 3 months after the cataract surgeries .Best corrected visual acuity was 0.1~0.4 in 8 eyes and higher than 0.5 in 4 eyes.Corneal edema was mild to moderate .There was no bulloulskeratop-athyreported during follow-up period.The rate of endothelial cell loss was 8.83%.Conclusion Cataract in eyes with low endothelial cell density may be treated withphacoemulsification and IOL implantation in selected patients .The keys to a-chieve satisfactory clinical outcomes include careful screening for indications , protect of endothelium during the operation , and being operated by experienced ophthalmologists .