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目的 :观察超声乳化白内障摘除术对角膜内皮细胞的影响 ,探讨评价白内障超声乳化术安全性的客观指标。 方法 :分别选择老年性白内障行超声乳化摘除及人工晶体植入术和囊外摘除及人工晶体植入术各 30例 ,利用计算机辅助的接触型角膜内皮显微镜观测术前术后角膜内皮细胞密度及形态的动态变化 ,并对视力、散光及其它并发症进行监测分析。 结果 :超声乳化组角膜内皮丢失率为 2 2 .0 % ,囊外组为2 0 .9% ,手术前后内皮细胞密度、平均细胞面积及变异系数、六角形细胞所占比例均有显著性差异 ( P<0 .0 5) ,术后 1周、术后 1月、术后 3月之间无显著性差异 ( P>0 .0 5) ,两组之间 ,差异无显著性。结论 :超声乳化白内障摘除及后房型人工晶体植入术对角膜内皮的损伤不大于白内障囊外摘除及后房型人工晶体植入术 ,术中角膜内皮细胞的丧失是角膜水肿的主要原因。
Objective: To observe the effect of phacoemulsification cataract extraction on corneal endothelial cells and to evaluate the objective evaluation of the safety of cataract phacoemulsification. Methods: Thirty patients with senile cataract who underwent phacoemulsification, intraocular lens implantation and extracapsular cataract extraction and intraocular lens implantation were selected respectively. The corneal endothelial cell density was measured by computer-assisted contact corneal endothelium microscope Dynamic changes in morphology, and visual acuity, astigmatism and other complications were monitored and analyzed. Results: The corneal endothelial loss rate was 22.0% in the phacoemulsification group and 20.9% in the extracapsular group. The density of endothelial cells, the average cell area, the coefficient of variation and the proportion of hexagonal cells before and after surgery were significantly different (P <0.05). There was no significant difference between the two groups after 1 week, 1 month and 3 months after operation (P> 0.05). There was no significant difference between the two groups. CONCLUSION: Phacoemulsification and posterior chamber intraocular lens implantation have less damage to the corneal endothelium than extracapsular cataract extraction and posterior chamber intraocular lens implantation. Intraocular corneal endothelial cell loss is the main reason of corneal edema.