眼科学报（英文版）
眼科學報（英文版）
안과학보（영문판）
Eye Science
2015年
3期
106-109
,共4页
非超声乳化白内障手术%核硬度%娩核%角膜内皮细胞
非超聲乳化白內障手術%覈硬度%娩覈%角膜內皮細胞
비초성유화백내장수술%핵경도%면핵%각막내피세포
non-phacoemulsification cataract operation%nuclear hardness%nuclear delivery%corneal en-dothelial cells
目的：探讨非超声乳化白内障手术两种不同的娩核方式对角膜内皮细胞数量和形态的影响，以及对术后视力恢复情况的影响。方法：选择在本院手术治疗的40例白内障患者娩核方式分为直接娩出组和半娩出组，并根据Emery－little晶状体核硬度分级标准分为软核和硬核，手术方式为白内障非超声乳化手术，术后第3天用角膜内皮镜检查并记录角膜内皮细胞数量和形态。术后随访3个月，比较并观察4组患者术前和术后角膜内皮细胞丢失率、形态变化和视力恢复情况。结果：术前和术后3个月角膜内皮细胞丢失率比较，硬核直接娩出组与另外三组比较差异有统计学意义（P＜0．01），而软核直接娩出组、硬核半娩出组与软核半娩出组比较差异无统计学意义（P＞0．05）。术前和术后第二天视力比较硬核半娩出组和软核直接娩出组之间无统计学意义（P＝0．49），软核半娩出组与这两组比较有统计学意义（P＝0．03），硬核直接娩出组与这两组之间比较也有统计学意义（P＝0．14），术后三个月视力比较4组之间均无统计学意义（P＝0．067）。术后3个月角膜内皮细胞形态变化不明显。结论：白内障非超声乳化手术时，硬核直接娩核法对角膜内皮细胞损伤最大，软核半娩核法对角膜内皮损伤最小。若内皮细胞损伤较轻，对手术3个月后视力和角膜内皮细胞形态无明显影响。眼科学报2015：30：106－109．
目的：探討非超聲乳化白內障手術兩種不同的娩覈方式對角膜內皮細胞數量和形態的影響，以及對術後視力恢複情況的影響。方法：選擇在本院手術治療的40例白內障患者娩覈方式分為直接娩齣組和半娩齣組，併根據Emery－little晶狀體覈硬度分級標準分為軟覈和硬覈，手術方式為白內障非超聲乳化手術，術後第3天用角膜內皮鏡檢查併記錄角膜內皮細胞數量和形態。術後隨訪3箇月，比較併觀察4組患者術前和術後角膜內皮細胞丟失率、形態變化和視力恢複情況。結果：術前和術後3箇月角膜內皮細胞丟失率比較，硬覈直接娩齣組與另外三組比較差異有統計學意義（P＜0．01），而軟覈直接娩齣組、硬覈半娩齣組與軟覈半娩齣組比較差異無統計學意義（P＞0．05）。術前和術後第二天視力比較硬覈半娩齣組和軟覈直接娩齣組之間無統計學意義（P＝0．49），軟覈半娩齣組與這兩組比較有統計學意義（P＝0．03），硬覈直接娩齣組與這兩組之間比較也有統計學意義（P＝0．14），術後三箇月視力比較4組之間均無統計學意義（P＝0．067）。術後3箇月角膜內皮細胞形態變化不明顯。結論：白內障非超聲乳化手術時，硬覈直接娩覈法對角膜內皮細胞損傷最大，軟覈半娩覈法對角膜內皮損傷最小。若內皮細胞損傷較輕，對手術3箇月後視力和角膜內皮細胞形態無明顯影響。眼科學報2015：30：106－109．
목적：탐토비초성유화백내장수술량충불동적면핵방식대각막내피세포수량화형태적영향，이급대술후시력회복정황적영향。방법：선택재본원수술치료적40례백내장환자면핵방식분위직접면출조화반면출조，병근거Emery－little정상체핵경도분급표준분위연핵화경핵，수술방식위백내장비초성유화수술，술후제3천용각막내피경검사병기록각막내피세포수량화형태。술후수방3개월，비교병관찰4조환자술전화술후각막내피세포주실솔、형태변화화시력회복정황。결과：술전화술후3개월각막내피세포주실솔비교，경핵직접면출조여령외삼조비교차이유통계학의의（P＜0．01），이연핵직접면출조、경핵반면출조여연핵반면출조비교차이무통계학의의（P＞0．05）。술전화술후제이천시력비교경핵반면출조화연핵직접면출조지간무통계학의의（P＝0．49），연핵반면출조여저량조비교유통계학의의（P＝0．03），경핵직접면출조여저량조지간비교야유통계학의의（P＝0．14），술후삼개월시력비교4조지간균무통계학의의（P＝0．067）。술후3개월각막내피세포형태변화불명현。결론：백내장비초성유화수술시，경핵직접면핵법대각막내피세포손상최대，연핵반면핵법대각막내피손상최소。약내피세포손상교경，대수술3개월후시력화각막내피세포형태무명현영향。안과학보2015：30：106－109．
Purpose:.To investigate the effect of non-phacoemulsification cataract operation in two different patterns of nucleus delivery on the quantity and morphology of corneal endothelial cells and postoperative visual acuity. Methods:.Forty patients diagnosed with cataract underwent cataract surgery and were assigned into the direct nuclear delivery and semi-nuclear delivery groups..Lens density was measured and divided into the hard and soft lenses according to Emery-little lens nucleus grading system..Non-phacoemulsification cataract operation was performed. At 3 d after surgery , the quantity and morphology of corneal endothe-lium were counted and observed under corneal endothelial microscope. During 3-month postoperative fol-low-up,.the endothelial cell loss rate,.morphological changes and visual acuity were compared among four groups. Results:.Corneal endothelial cell loss rate in the direct delivery of hard nucleus group significantly dif-fered from those in the other three groups before and 3 months after operation (P<0.01), whereas no sta-tistical significance was found among the direct delivery of soft nucleus , semi-delivery of hard nucleus and semi-delivery soft nucleus groups (all P>0.05). Preoperative and postoperative 2-d visual acuity did not differ between the semi-delivery of hard nucleus and direct delivery of soft nucleus groups (P=0.49),significantly differed from those in the semi-delivery of soft nucleus (P=0.03) and direct delivery of hard nucleus groups(P=0.14). Visual acuity at postoperative four months did not differ among four groups (P=0.067). Conclusion:.During non-phacoemulsification cataract surgery, direct delivery of hard nucleus caused severe injury to corneal endothelium and semi-delivery of soft nucleus yielded mild corneal en-dothelial injury. Slight corneal endothelial injury exerted no apparent effect upon visual acuity and corneal endothelial morphology at three months after surgery.
