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目的观察白内障超声乳化摘除术对不同核硬度年龄相关性白内障患者角膜内皮细胞的影响。方法采用病例对照研究,将147例患者147眼白内障手术患者按术前晶状体核级别水平分为两组:A组轻度核,74例74眼;B组重度核,73例73眼。采用角膜内皮镜检测术前、术后1周的光学区角膜内皮细胞密度改变情况;术前、术后统计视力及眼前段表现;术中统计超声平均能量与作用时间。结果术前各组患者角膜内皮细胞密度、变异系数等比较差异未见统计学意义。手术前角膜内皮细胞平均值与手术后平均值比较差异未见统计学意义;Ⅱ级核、Ⅲ级核、Ⅳ级核及Ⅴ级核内术前与术后角膜内皮细胞平均值比较差异未见统计学意义;术后常见并发症为角膜水肿及角膜内皮细胞皱褶,仅在Ⅳ级及Ⅴ级核中发现,伴有内皮细胞数量低于1130,且所需超声乳化时间能量及时间明显超过未发生组,差异均有统计学意义(P<0.05)。结论重度核伴低角膜内皮细胞数易导致白内障超声乳化术后手术并发症。
Objective To observe the effect of phacoemulsification on corneal endothelial cells in age-related cataract patients with different nuclear hardness. Methods A case-control study was conducted in 147 eyes of 147 patients with cataract surgery. The patients were divided into two groups according to the level of preoperative lens nucleus: mild nuclei in group A, 74 eyes in 74 cases, severe nuclei in group B and 73 eyes in 73 cases. Corneal endoscopy was used to detect the changes of corneal endothelial cell density before and 1 week after operation. The visual acuity and anterior segment of the optic zone were measured before and after surgery. The intraoperative ultrasound average energy and time were recorded. Results There was no significant difference in corneal endothelial cell density, coefficient of variation, etc. before operation in all groups. There was no significant difference between the mean values of corneal endothelial cells before operation and the average value after operation. There was no significant difference between the mean preoperative and postoperative corneal endothelial cells in grade Ⅱ, Ⅲ, Ⅳ and Ⅴ nuclei Statistical significance; common postoperative complications of corneal edema and corneal endothelial cell folds, found only in grade Ⅳ and Ⅴ nuclei, with the number of endothelial cells is less than 1130, and the required phacoemulsification time energy and time significantly exceeded No group, the difference was statistically significant (P <0.05). Conclusions Severe nuclear accompanied with low corneal endothelial cells may lead to postoperative complications of phacoemulsification.