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[摘要]
目的:观察角膜内皮形态异常白内障患者行白内障超声乳化吸除联合人工晶状体(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2018-01/2020-01在新疆医科大学第一附属医院确诊为年龄相关性白内障患者角膜内皮细胞密度(CD)>2 000cell/mm2,但形态异常的72例90眼作为病例组,以形态正常的120例158眼作为对照组,分别行白内障超声乳化吸除联合IOL植入术,检测术前、术后1wk,1、3mo时CD、细胞面积变异系数(CV)、角膜内皮六角形细胞百分比(HEX)、中央角膜厚度(CT)的变化,分析两组间的差异。
结果:两组患者CD、CV、HEX、CT术后1wk,1mo比较均有差异,而术后3mo两组间CD、HEX有差异,而CV、CT无差异。
结论:CD正常而形态异常的白内障患者行超声乳化吸除联合IOL植入术后角膜内皮损伤程度更重,术前应充分重视,术中同样需要保护角膜内皮,谨慎操作。
[Key word]
[Abstract]
AIM: To observe the safety and effect of cataract extraction combined with intraocular lens(IOL)implantation surgery in patients with abnormal morphology of corneal endothelium.
METHODS: We collected 72(90 eyes)age related cataract patients with abnormal morphology of corneal endothelium and 120(158 eyes)patients with normal morphology of corneal endothelium from January 2018 to January 2020 in our hospital. All of them measured corneal endothelial cell density(CD)>2 000cell/mm2 and underwent phacoemulsification combined with IOL implantation. CD, coefficient of variation(CV), frequency of hexagonal cells(HEX), central corneal thickness(CT)were recorded at 1wk, 1, 3mo postoperatively and compared in each group.
RESULTS:There were significant differences in endothelial CD, CV, HEX and CT between the two groups 1wk and 1mo postoperative, while there were significant differences in CD and HEX between the two groups after 3mo, but there were no significant differences in CV and CT.
CONCLUSION: Endothelial damage after phacoemulsification in abnormal morphology of corneal endothelium group is comparable to that in control group, and we should pay more attention to the examination of corneal endothelium, especially the corneal endothelial cells morphology before operation and protect it during operation.
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