目的：研究角膜内皮细胞(ECD)低下白内障患者超声乳化人工晶状体植入术后应用重组牛碱性成纤维细胞生长因子(re-bFGF)的效果。

方法：前瞻性研究。选取2021年1月至2023年12月于本院行超声乳化人工晶状体植入术治疗的ECD低下白内障患者82例82眼，应用随机抛硬币法分为观察组(41眼)和对照组(41眼)。两组均行超声乳化人工晶状体植入术治疗，术后均进行常规治疗，对照组在常规治疗基础上联合重组人表皮生长因子(rhEGF)滴眼液治疗，每次1-2滴，4次/日； 观察组在常规治疗基础上联合re-bFGF滴眼液治疗，每次1-2滴，4次/日，两组均连续用药3 mo。比较两组患者术后裸眼视力恢复情况、角膜相关指标差异\〖ECD、中央角膜厚度(CCT)、细胞面积变异系数(CV)、角膜内皮六角形细胞百分比(HEX)\〗、泪液炎性因子\〖术前术后的肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)\〗、并发症。

结果：两组患者术前一般资料比较均无差异。所有患者均完成随访。两组术后1 wk，1、3 mo视力均较术前改善(均P<0.05)。术后1 wk，1、3 mo，观察组角膜ECD、HEX水平高于对照组，CCT、CV水平低于对照组(均P<0.05)。术后3 mo，观察组泪液中TNF-α、IL-1β和IL-6水平均低于对照组(均P<0.05)； 观察组并发症的总发生率低于对照组，但差异无统计学意义(P>0.05)。

结论：ECD低下的白内障患者超声乳化人工晶状体植入术后应用re-bFGF具有较好的临床价值，能减轻角膜损伤，降低炎症负担。

METHODS: Prospective study. A total of 82 patients(82 eyes)with cataract and low ECD who received phacoemulsification and intraocular lens implantation in the hospital from January 2021 to December 2023 were selected and divided into observation group(41 eyes)and control group(41 eyes)by random coin tossing method. Both groups were treated with phacoemulsification and intraocular lens implantation, and received postoperative routine treatment. The control group was administrated with recombinant human epidermal growth factor(rhEGF)eye drops(1-2 drops each time, 4 times/day)on the basis of routine treatment, while the observation group was given re-bFGF eye drops(1-2 drops each time, 4 times/day)on the basis of routine treatment, and both groups were treated continuously for 3 mo. The postoperative uncorrected visual acuity recovery, cornea-related indicators \〖ECD, central corneal thickness(CCT), coefficient of variation in cell area(CV), percentage of corneal endothelial hexagonal cells(HEX)\〗, serum inflammatory factors \〖tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β)and interleukin-6(IL-6)before and after surgery\〗 and complications were compared between the two groups of patients.

RESULTS: There were no differences in preoperative general data between the two groups. At 1 wk, 1 and 3 mo after surgery, the visual acuity in the two groups was improved compared with that before surgery(all P<0.05). The levels of corneal ECD and HEX in the observation group at 1 wk, 1 and 3 mo after surgery were higher than those in the control group, while the levels of CCT and CV were lower than those in the control group(all P<0.05). At 3 mo after surgery, levels of TNF-α, IL-1β and IL-6 in tears were lower in the observation group compared to the control group(all P<0.05). The total incidence rate of complications in the observation group was lower than that in the control group, with no statistical significance(P>0.05).

CONCLUSION: The application of re-bFGF in cataract patients with low ECD after phacoemulsification and intraocular lens implantation has good clinical value. Additionally, it can relieve the corneal injury, and reduce the burden of inflammation.