白内障超声乳化术后早期区域性角膜水肿的临床研究

发布时间：2018-04-28 22:22

本文选题：白内障超声乳化 + 角膜内皮细胞　；参考：《同济大学学报(医学版)》2016年01期

【摘要】：目的探讨白内障超声乳化术后早期区域性角膜水肿的临床特征。方法收集行白内障超声乳化联合人工晶体植入术的患者50例(50只眼)。采用角膜内皮显微镜(corneal specular microscope,CSM)对手术前后角膜中央、12点、3点、6点及9点位的5个象限,每一象限的5个区域总共25个位置的角膜内皮细胞(corneal endothelial cells,CECs)进行拍照、图像合并及数字化分析。采用眼前节光学相干断层扫描仪(anterior segment optical coherence tomography,AS-OCT)获取白内障手术前后全角膜厚度图,分析区域性角膜水肿与区域性CECs密度(corneal endothelial cell density,CD)改变的相关性。结果入组50例手术均顺利实施,随访期(12.5±1.1)个月。5个象限共25个位置CEC数据显示:术后1 d,平均CD为(2 045±153)个/mm2,较术前平均(2 557±265)个/mm2差异有统计学意义(P0.01)。与中央区参数相比,12、3、6、9点位CD差异均存在统计学意义(P0.01)。术后1 d,在中央、12、6、9、3点位,角膜厚度变化分别为(162.7±84.8)、(285.1±114.5)、(121.1±91.2)、(257.2±123.4)、(145.1±91.4)μm,均较术前增加(P均0.01)。术后1 d,区域性CD减少与区域性角膜水肿存在正相关(r=0.87,P=0.001)。结论白内障术后区域性的角膜厚度增加可间接反映区域性CD减少的程度。
[Abstract]:Objective to investigate the clinical features of early regional corneal edema after phacoemulsification. Methods 50 cases of cataract phacoemulsification combined with intraocular lens implantation were collected. Corneal specular microscopec microscopes were used to take photographs of corneal endothelial cells (endothelial cells) in 5 quadrants of the central cornea at 12 o'clock, 3 o'clock, 6 o'clock and 9 o'clock before and after operation, and a total of 25 locations in 5 regions of each quadrant. Image merging and digital analysis. The whole corneal thickness map before and after cataract surgery was obtained by anterior segment optical coherence tomographygraphy (AS-OCT), and the correlation between regional corneal edema and regional CECs density endothelial cell density (CECs) was analyzed. Results all the 50 patients in the group were performed successfully, the follow-up period was 12.5 卤1.1 months. The CEC data of 25 locations in 5 quadrants showed that the mean CD was 2 045 卤153 / mm 2 at 1 day after operation, which was significantly higher than that of the preoperative mean of 2 557 卤265 / mm 2 / mm2 (P 0.01). Compared with the central area parameters, there were significant differences in CD values at 12 ~ 12 ~ 3 ~ 6 ~ 6 ~ (th) ~ (th) ~ (th) ~ (th) point (P _ (0.01)). On the 1st day after operation, the corneal thickness changes were 162.7 卤84.8U / L and 121.1 卤91.2 卤91.2 卤91.4) 渭 m respectively, which were significantly higher than those before operation (P < 0.01). On the 1st day after operation, there was a positive correlation between regional CD reduction and regional corneal edema. Conclusion the increase of regional corneal thickness after cataract surgery can indirectly reflect the extent of regional CD reduction.
【作者单位】：同济大学附属同济医院眼科;
【基金】：国家自然科学基金(30973247)
【分类号】：R779.66

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