CAJ | 학술논문

目的：探讨白内障超声乳化术对糖尿病患者角膜内皮细胞的影响及角膜厚度的变化。方法选取白内障超声乳化手术的患者107例（134只眼）分为3组：①单纯老年性白内障患者62例（65只眼）为对照组；②糖尿病患者21例（31只眼）；③合并高血压的糖尿病患者24例（38只眼）。应用角膜内皮显微镜观察手术前及术后2天、1周、1个月的中央角膜内皮密度（CCD）、变异系数（CV）、六角形细胞百分比（6A％）及中央角膜厚度（CCT）的变化。结果术前2个糖尿病组与对照组比较：CCD、CV、6A％差异无显著性（ P ＞0．05），CCT差异有显著性（ P＜0．05）；术后2 d、1周、1个月CCD、6A％3组均较术前下降，CV增加，差异均有显著性（均为P ＜0．05）；CCT在术后2 d、1周较术前增厚，合并高血压的糖尿病组较糖尿病组进一步增厚（均为P ＜0．05）；术后各时间段2个糖尿病组CCD与相应对照组无明显统计学差异（ P ＞0．05），CV、CCT均高于相应对照组，6A％下降，差异均有显著性（均为P ＜0．05）。结论超声乳化手术对角膜内皮及角膜厚度有影响，糖尿病患者内皮损害加重，合并高血压的糖尿病患者手术后角膜厚度增加更明显。
목적：탐토백내장초성유화술대당뇨병환자각막내피세포적영향급각막후도적변화。방법선취백내장초성유화수술적환자107례（134지안）분위3조：①단순노년성백내장환자62례（65지안）위대조조；②당뇨병환자21례（31지안）；③합병고혈압적당뇨병환자24례（38지안）。응용각막내피현미경관찰수술전급술후2천、1주、1개월적중앙각막내피밀도（CCD）、변이계수（CV）、륙각형세포백분비（6A％）급중앙각막후도（CCT）적변화。결과술전2개당뇨병조여대조조비교：CCD、CV、6A％차이무현저성（ P ＞0．05），CCT차이유현저성（ P＜0．05）；술후2 d、1주、1개월CCD、6A％3조균교술전하강，CV증가，차이균유현저성（균위P ＜0．05）；CCT재술후2 d、1주교술전증후，합병고혈압적당뇨병조교당뇨병조진일보증후（균위P ＜0．05）；술후각시간단2개당뇨병조CCD여상응대조조무명현통계학차이（ P ＞0．05），CV、CCT균고우상응대조조，6A％하강，차이균유현저성（균위P ＜0．05）。결론초성유화수술대각막내피급각막후도유영향，당뇨병환자내피손해가중，합병고혈압적당뇨병환자수술후각막후도증가경명현。
Objective To investigate the effect of phacoemulsification on corneal endothelium and corneal thick -ness of diabetic patients .Methods 107 patients (134 eyes) who underwent phacoemulsification were included .They were classified into 3 groups.62 senile cataract patients (65 eyes) without diabetes mellitus and hypertension were taken as con-trol group.There were 21 patients (31 eyes) in diabetes group.24 patients (38 eyes) were in the diabetes combined with hypertension group.Assessments of central corneal endothelial density (CCD), coefficient of variation of cell area (CV), percentage of hexagonal cells (6A%) and central corneal thickness (CCT) were done by specular microscopy on preopera-tion and postoperative 2 days,1 week and 1 month.Results There was no significant difference in preoperative CCD , CV, 6A%when two diabetic groups compared with control group ( P >0.05), while the difference of CCT was significant ( P<0.05).CCD and 6A%dropped significantly and CV increased significantly in three groups on postoperative 2 days, 1 week(average P <0.05).Change of CCT was significant higher on postoperative 2 days and 1 week in three groups.CCT in diabetes combined with hypertension group was significant higher than that in diabetes group on post -operative 2 days, 1 week( both P <0.05) .There were no significant differences in postoperative CCD when two diabetes compared with con -trol group( P >0.05), while CV and CCT were significant higher and 6A%was significant lower(both P <0.05).Con-clusions Phacoemulsification have impact on corneal endothelium and corneal thickness .The damage to endothelium in patients with diabetes mellitus was more severe .The change of corneal thickness after cataract surgery was much thicker in patients with diabetes combined with hypertension .