中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2014年
1期
41-44
,共4页
Fuchs角膜内皮营养不良%超声乳化白内障吸除术%白内障摘除术%人工晶状体
Fuchs角膜內皮營養不良%超聲乳化白內障吸除術%白內障摘除術%人工晶狀體
Fuchs각막내피영양불량%초성유화백내장흡제술%백내장적제술%인공정상체
Fuchs endothelial dystrophy%Phacoemulsification%Cataract extraction%Intraocular lens
目的 观察Fuchs角膜内皮营养不良(FED)患者行白内障摘除联合IOL植入术的安全性及手术效果.方法 回顾性系列病例研究.对2009年12月至2012年12月在青岛眼科医院确诊为FED合并有白内障的18例患者(30眼)分别行白内障超声乳化摘除联合IOL植入术(27眼)或白内障囊外摘除联合IOL植入术(3眼).观察手术前后角膜内皮细胞密度(CD)、细胞面积变异系数(CV)、中央角膜厚度(CCT)以及视力、眼压的变化,分析影响角膜内皮细胞变化的因素.数据采用配对t检验、Wilcoxon秩和检验、Pearson相关进行分析.结果 30眼中有5眼术前术后CD测不出,其余25眼手术前后CV差异无统计学意义(t=0.444,P＞0.05),手术前后CD分别为(2 270.6±559.0)cells/mm2和(1 750.4±585.0) cells/mm2,差异有统计学意义(t=4.759,P＜0.01).角膜内皮细胞丢失率为(21.78±20.67)％.术后CCT为(543.0±34.5) μm,术后视力较术前提高(Z=-4.693,P＜0.01).术后CCT与术后CD(r=-0.428,P＜0.05)、CV (r=0.434,P＜0.05)显著相关.术后角膜内皮细胞丢失率与累积释放能量呈正相关(r=0.466,P＜0.01).无一例发生角膜内皮功能失代偿.结论 FED患者行白内障摘除联合IOL植入术是安全、有效的,术中应采取相应措施尽量减少内皮细胞的损伤.
目的 觀察Fuchs角膜內皮營養不良(FED)患者行白內障摘除聯閤IOL植入術的安全性及手術效果.方法 迴顧性繫列病例研究.對2009年12月至2012年12月在青島眼科醫院確診為FED閤併有白內障的18例患者(30眼)分彆行白內障超聲乳化摘除聯閤IOL植入術(27眼)或白內障囊外摘除聯閤IOL植入術(3眼).觀察手術前後角膜內皮細胞密度(CD)、細胞麵積變異繫數(CV)、中央角膜厚度(CCT)以及視力、眼壓的變化,分析影響角膜內皮細胞變化的因素.數據採用配對t檢驗、Wilcoxon秩和檢驗、Pearson相關進行分析.結果 30眼中有5眼術前術後CD測不齣,其餘25眼手術前後CV差異無統計學意義(t=0.444,P＞0.05),手術前後CD分彆為(2 270.6±559.0)cells/mm2和(1 750.4±585.0) cells/mm2,差異有統計學意義(t=4.759,P＜0.01).角膜內皮細胞丟失率為(21.78±20.67)％.術後CCT為(543.0±34.5) μm,術後視力較術前提高(Z=-4.693,P＜0.01).術後CCT與術後CD(r=-0.428,P＜0.05)、CV (r=0.434,P＜0.05)顯著相關.術後角膜內皮細胞丟失率與纍積釋放能量呈正相關(r=0.466,P＜0.01).無一例髮生角膜內皮功能失代償.結論 FED患者行白內障摘除聯閤IOL植入術是安全、有效的,術中應採取相應措施儘量減少內皮細胞的損傷.
목적 관찰Fuchs각막내피영양불량(FED)환자행백내장적제연합IOL식입술적안전성급수술효과.방법 회고성계렬병례연구.대2009년12월지2012년12월재청도안과의원학진위FED합병유백내장적18례환자(30안)분별행백내장초성유화적제연합IOL식입술(27안)혹백내장낭외적제연합IOL식입술(3안).관찰수술전후각막내피세포밀도(CD)、세포면적변이계수(CV)、중앙각막후도(CCT)이급시력、안압적변화,분석영향각막내피세포변화적인소.수거채용배대t검험、Wilcoxon질화검험、Pearson상관진행분석.결과 30안중유5안술전술후CD측불출,기여25안수술전후CV차이무통계학의의(t=0.444,P＞0.05),수술전후CD분별위(2 270.6±559.0)cells/mm2화(1 750.4±585.0) cells/mm2,차이유통계학의의(t=4.759,P＜0.01).각막내피세포주실솔위(21.78±20.67)％.술후CCT위(543.0±34.5) μm,술후시력교술전제고(Z=-4.693,P＜0.01).술후CCT여술후CD(r=-0.428,P＜0.05)、CV (r=0.434,P＜0.05)현저상관.술후각막내피세포주실솔여루적석방능량정정상관(r=0.466,P＜0.01).무일례발생각막내피공능실대상.결론 FED환자행백내장적제연합IOL식입술시안전、유효적,술중응채취상응조시진량감소내피세포적손상.
Objective To evaluate the effect of Fuchs endothelial dystrophy (FED) on the corneal endothelial cells of patients undergoing cataract surgery.Methods In this retrospective case series study,18 patients (30 eyes) with FED who were treated at Qingdao Eye Hospital from December 2009 to December 2012 were included.Twenty-seven eyes underwent phacoemulsification,and extracapsular cataract extraction was performedon 3 eyes.Corneal endothelial cell density (CD),the coefficient of variation of the cell area (CV),central corneal thickness (CCT),visual acuity and intraocular pressure were evaluated and statistical analyses were performed.Data were analyzed using a paired t test,Wilcoxon ranks test and Pearson correlation.Results The preoperative CD of five eyes could not be determined.The difference between preoperative and postoperative CV in the remaining 25 eyes was not statistically significant (t=0.444,P＞0.05).The preoperative and postoperative CDs were 2 270.6±559.0 cells/mm2 and 1 750.4±585.0 cells/mm2,respectively (t=4.759,P＜0.01).The loss rate for endothelial cells was 21.78±20.67％.The postoperative CCT in all FED patients was 543.0±34.5 μm.Postoperative visual acuity improved significantly compared with preoperative visual acuity (Z=-4.693,P＜0.01).Postoperative CCT was significantly correlated with postoperative CD (r=-0.428,P＜0.05) and CV (r=0.434,P＜0.05).The loss rate of corneal endothelial cells was significantly correlated with the cumulative dissipated energy (r=-0.466,P＜0.01).No bullous keratopathy occurred in any patients during the follow-up period.Conclusion Cataract extraction and intraocular lens implantation is safe and effective for patients with FED.Some measures should be taken into consideration to reduce the loss of endothelial cells.
