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[摘要]
目的:比较前房维持器与黏弹剂对超声乳化术后角膜散光度及内皮细胞的影响。
方法:选取本院2013-04/2015-04期间收治的70例70眼白内障患者,并随机分为研究组和对照组各35例35眼。研究组患者采用前房维持器下超声乳化进行治疗,对照组患者采用黏弹剂下超声乳化进行治疗。观察两组术前、术后1mo角膜散光和角膜内皮细胞密度的变化情况。
结果:两组年龄、术前角膜内皮细胞密度和角膜散光度均无统计学差异(t=0.215,P=0.831; t=-0.352,P=0.726; t=-0.162,P=0.872); 两组术前和术后1mo时的视力(LogMAR)比较均无统计学差异(P>0.05); 而研究组术前和术后1mo时的裸眼视力及对照组术前和术后1mo时的裸眼视力比较,均有统计学差异(P<0.05),术后视力较术前具有显著性提高; 研究组术前和术后1mo时的角膜内皮细胞密度和角膜散光度具有统计学差异(t=8.489,P<0.01; t=-2.032,P=0.046); 对照组术前和术后1mo时的角膜内皮细胞密度和角膜散光度的比较也具有统计学差异(t=8.999,P<0.01; t=-2.167,P=0.034)。两组术后1mo角膜内皮细胞丢失率间的差异无统计学意义(P>0.05)。
结论:相比黏弹剂,使用前房维持器下超声乳化治疗白内障患者,术后并未增加患者术源性散光和角膜内皮细胞的损伤,进一步证明使用超声乳化吸除术配合前房维持器治疗白内障是安全有效的。
[Key word]
[Abstract]
AIM: To compare the influence of anterior chamber maintainer and viscoelastic agent on corneal astigmatism and endothelial cells after phacoemulsification.
METHODS: Totally 70 patients(70 eyes)of cataract from April 2013 to April 2015 were randomly divided into the study group and the control group, with 35 cases in each group. The study group were treated with anterior chamber maintainer during phacoemulsification with support system approach, and the control group were treated with phacoemulsification under viscoelastic agent.
RESULTS:The age(t=0.215, P=0.831), the density of corneal endothelial cells(t=-0.352, P=0.726)and corneal luminosity(t=-0.162, P=0.872)of two groups had no significant difference before surgery; there were no significant difference in preoperative visual acuity(t=0.463, P=0.599)and visual acuity(t=1.616, P=0.124)at 1mo after operation. And patients in the study group(t=-21.129, P<0.01)and the control group(t=-12.780, P<0.01)before surgery and 1mo postoperative when compared with the naked eye eyesight showed significant difference. The visual acuity after operations improved significantly. There were significant differences of corneal endothelial cells density(t=8.489, P< 0.01)and corneal astigmatism(t=-2.032, P=0.046)in the study group before surgery and 1mo after surgery; corneal endothelial cell density(t=8.999, P<0.01)and corneal astigmatism(t=-2.167, P=0.034)in the control group before surgery and 1mo after surgery also had significant differences. There was no significant difference in the rate of corneal endothelial cell loss between the two groups(t=0.410, P=0.683).
CONCLUSION: Compared with viscoelastic agent, anterior chamber maintainer during phacoemulsification in patients with cataract won't increase the damage of postoperative surgically induced astigmatism and corneal endothelial cells, which mean the method of anterior chamber maintainer during phacoemulsification in the treatment of cataract is safe and effective.
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