不同切口超声乳化术对年龄相关性白内障患者角膜内皮和泪膜功能的影响
|
摘要
目的:探讨不同切口白内障超声乳化手术对年龄相关性白内障患者角膜内皮和泪膜功能的影响。方法:将我院收治的年龄相关性白内障患者90例90眼随机分为2.2mm组(47例47眼,行2.2mm角膜微切口白内障超声乳化手术)和3.0mm组(43例43眼,行3.0mm透明角膜切口白内障超声乳化手术),比较两组患者角膜内皮功能、泪膜功能等指标的变化。结果:两组患者术中平均超声乳化时间(APT)、平均有效超声乳化时间(EPT)、平均超声乳化能量(AVE)及术前和术后1wk眼压分别进行比较,差异均无统计学意义(P>0.05)。两组患者手术前后不同时间泪膜破裂时间(BUT)、基础泪液分泌试验(ST-Ⅱ)、角膜荧光素钠染色(SCSF)评分、角膜内皮细胞(CEC)计数、中央角膜厚度、CEC变异系数比较,差异均有统计学意义(P<0.05);两组术后1wk,1mo BUT均明显低于术前(P<0.05),ST-Ⅱ均显著高于术前(P<0.05),SCSF评分先升高后下降且均高于术前(P<0.05),CEC计数均明显低于术前(P<0.05),中央角膜厚度和CEC变异系数均显著高于术前(P<0.05);2.2mm组术后BUT、ST-Ⅱ、SCSF评分、CEC计数、中央角膜厚度及CEC变异系数变化幅度均小于3.0mm组。结论:2.2mm和3.0mm白内障超声乳化手术对年龄相关性白内障患者角膜内皮功能和泪膜功能可造成一定损害,2.2mm角膜微切口的损害更小,术后早期恢复更快。
AIM: To explore the effect of different incision phacoemulsification on corneal endothelial function and tear film function in senile cataract(SC) patients.· METHODS: Totally 90 SC patients(90 eyes) admitted to our hospital were randomly divided into the 2.2 mm group(n = 47,47 eyes, 2. 2 mm corneal micro-incision phacoemulsification) and the 3.0 mm group(n = 43,43 eyes, 3. 0 mm clear corneal micro-incision phacoemulsification). The indexes of corneal endothelial function and tear film function were compared between the two groups before and after operation.· RESULTS: There was no statistical difference on the average phacoemulsification time(APT),mean effective phacoemulsification time( EPT), average phacoemulsification energy(AVE) and preoperative and postoperative intraocular pressure between the two groups(P>0.05). There were statistical differences on the tear break-up time(BUT),basal tear secretion test(STII),corneal sodium fluorescein staining(SCSF) score,corneal endothelial cell count,central corneal thickness and the variation coefficient of corneal endothelial cells between the two groups(P<0. 05). At 1 wk and 1 mo after operation, the BUT in the two groups was significantly lower than that before operation(P<0. 05) while the STII was significantly higher than that before operation(P<0.05),and the SCSF first increased and then decreased(P < 0. 05),and corneal endothelial cell count was significantly lower than that before operation(P<0. 05),and the central corneal thickness and the variation coefficient of corneal endothelial cells significantly increased(P<0. 05). The changed degrees of BUT, STII,SCSF score, corneal endothelial cell count, central corneal thickness and corneal endothelial cell variation coefficient in the 2.2 mm group were less than those in the3.0 mm group(P<0.05).· CONCLUSION: Phacoemulsification for SC patients can cause some damage in corneal endothelial function and tear film function, and 2. 2 mm corneal micro-incision have less damage and faster early recovery.
AIM: To explore the effect of different incision phacoemulsification on corneal endothelial function and tear film function in senile cataract(SC) patients.· METHODS: Totally 90 SC patients(90 eyes) admitted to our hospital were randomly divided into the 2.2 mm group(n = 47,47 eyes, 2. 2 mm corneal micro-incision phacoemulsification) and the 3.0 mm group(n = 43,43 eyes, 3. 0 mm clear corneal micro-incision phacoemulsification). The indexes of corneal endothelial function and tear film function were compared between the two groups before and after operation.· RESULTS: There was no statistical difference on the average phacoemulsification time(APT),mean effective phacoemulsification time( EPT), average phacoemulsification energy(AVE) and preoperative and postoperative intraocular pressure between the two groups(P>0.05). There were statistical differences on the tear break-up time(BUT),basal tear secretion test(STII),corneal sodium fluorescein staining(SCSF) score,corneal endothelial cell count,central corneal thickness and the variation coefficient of corneal endothelial cells between the two groups(P<0. 05). At 1 wk and 1 mo after operation, the BUT in the two groups was significantly lower than that before operation(P<0. 05) while the STII was significantly higher than that before operation(P<0.05),and the SCSF first increased and then decreased(P < 0. 05),and corneal endothelial cell count was significantly lower than that before operation(P<0. 05),and the central corneal thickness and the variation coefficient of corneal endothelial cells significantly increased(P<0. 05). The changed degrees of BUT, STII,SCSF score, corneal endothelial cell count, central corneal thickness and corneal endothelial cell variation coefficient in the 2.2 mm group were less than those in the3.0 mm group(P<0.05).· CONCLUSION: Phacoemulsification for SC patients can cause some damage in corneal endothelial function and tear film function, and 2. 2 mm corneal micro-incision have less damage and faster early recovery.
引文
1金守梅,冯运红,谢静,等.小切口劈核法与超声乳化白内障摘除术治疗老年性硬核性白内障的疗效比较.蚌埠医学院学报2016;41(7):908-911
2 郑云燕,谢青,陈惠,等.超声乳化方式和小切口囊外摘除手术治疗膨胀期老年白内障的对比研究.湖南师范大学学报(医学版)2015;12(5):74-76
3 阳光,何异,范松涛.不同大小透明角膜切口对白内障超声乳化术后泪膜的影响.眼科新进展2015;35(12):1173-1176
4 高峰,王于蓝,陶津华.扭动超声与传统超声模式处理常规及硬核白内障的比较.国际眼科杂志2015;15(7):1245-1247
5 Badian R,Utheim TP,Rader S,et al.Evaluation of self-report questionnaires as predictive tests for obtaining pathological schirmer i,tear film break-up time and ocular protection index scores in dry eye disease patients.Acta Ophthalmol 2015;92(s253):57-62
6 邵毅,余瑶,裴重刚,等.功能性溢泪糖尿病患者下睑松弛矫正术后泪膜和泪液蛋白的特点.中国现代医学杂志2015;25(11):21-25
7 Na KS,Yoo YS,Hwang KY,et al.Tear Osmolarity and Ocular Surface Parameters as Diagnostic Markers of Ocular Graft-Versus-Host Disease.Am J Ophthalmol 2015;160(1):143-149
8 刘铮,谭少健,刘金华.白内障手术技术的研究进展.广西医科大学学报2015;32(3):516-518
9 吴杰.2.2mm和3.0mm透明角膜切口白内障超声乳化术后泪膜和眼表变化对比研究.临床和实验医学杂志2016;15(18):1790-1793
10 李科,林再雄,李雷,等.不同透明角膜切口白内障超声乳化术后眼表和泪膜的变化.国际眼科杂志2016;16(1):80-83
11 李晓鹏,李彦,焦军杰,等.白内障超声乳化术对泪膜功能的影响.国际眼科杂志2015;15(4):669-671
12 章成芝,徐青.同轴微切口白内障超声乳化术后泪膜及角膜规则性的研究.眼科新进展2016;36(6):559-562
13 赵娴,刘婕,左建霞,等.不同切口白内障超声乳化手术对糖尿病患者术后泪膜功能的影响.河北医科大学学报2016;37(8):932-934
14 张景尚,刘雪,王进达,等.不同大小透明角膜切口超声乳化术治疗放射状角膜切开术后白内障.中华眼视光学与视觉科学杂志2017;19(10):600-605
15 刘昳,袁进.不同大小透明角膜切口超声乳化术后早期稳定性的对比研究.眼科新进展2015;35(4):338-340
16 李宁,王剑锋,卜京丽,等.超声乳化白内障摘除术与小切口白内障摘除术对角膜内皮细胞影响的对比研究.中华全科医学2017;15(10):1666-1668
17 李玉红,马凌葵,笪荣峰,等.超声乳化白内障手术后患者角膜内皮细胞损伤的研究.现代生物医学进展2016;16(9):1707-1710
2 郑云燕,谢青,陈惠,等.超声乳化方式和小切口囊外摘除手术治疗膨胀期老年白内障的对比研究.湖南师范大学学报(医学版)2015;12(5):74-76
3 阳光,何异,范松涛.不同大小透明角膜切口对白内障超声乳化术后泪膜的影响.眼科新进展2015;35(12):1173-1176
4 高峰,王于蓝,陶津华.扭动超声与传统超声模式处理常规及硬核白内障的比较.国际眼科杂志2015;15(7):1245-1247
5 Badian R,Utheim TP,Rader S,et al.Evaluation of self-report questionnaires as predictive tests for obtaining pathological schirmer i,tear film break-up time and ocular protection index scores in dry eye disease patients.Acta Ophthalmol 2015;92(s253):57-62
6 邵毅,余瑶,裴重刚,等.功能性溢泪糖尿病患者下睑松弛矫正术后泪膜和泪液蛋白的特点.中国现代医学杂志2015;25(11):21-25
7 Na KS,Yoo YS,Hwang KY,et al.Tear Osmolarity and Ocular Surface Parameters as Diagnostic Markers of Ocular Graft-Versus-Host Disease.Am J Ophthalmol 2015;160(1):143-149
8 刘铮,谭少健,刘金华.白内障手术技术的研究进展.广西医科大学学报2015;32(3):516-518
9 吴杰.2.2mm和3.0mm透明角膜切口白内障超声乳化术后泪膜和眼表变化对比研究.临床和实验医学杂志2016;15(18):1790-1793
10 李科,林再雄,李雷,等.不同透明角膜切口白内障超声乳化术后眼表和泪膜的变化.国际眼科杂志2016;16(1):80-83
11 李晓鹏,李彦,焦军杰,等.白内障超声乳化术对泪膜功能的影响.国际眼科杂志2015;15(4):669-671
12 章成芝,徐青.同轴微切口白内障超声乳化术后泪膜及角膜规则性的研究.眼科新进展2016;36(6):559-562
13 赵娴,刘婕,左建霞,等.不同切口白内障超声乳化手术对糖尿病患者术后泪膜功能的影响.河北医科大学学报2016;37(8):932-934
14 张景尚,刘雪,王进达,等.不同大小透明角膜切口超声乳化术治疗放射状角膜切开术后白内障.中华眼视光学与视觉科学杂志2017;19(10):600-605
15 刘昳,袁进.不同大小透明角膜切口超声乳化术后早期稳定性的对比研究.眼科新进展2015;35(4):338-340
16 李宁,王剑锋,卜京丽,等.超声乳化白内障摘除术与小切口白内障摘除术对角膜内皮细胞影响的对比研究.中华全科医学2017;15(10):1666-1668
17 李玉红,马凌葵,笪荣峰,等.超声乳化白内障手术后患者角膜内皮细胞损伤的研究.现代生物医学进展2016;16(9):1707-1710