23G前段玻璃体切割术在浅前房低角膜内皮细胞密度白内障手术中的应用

发布时间：2018-10-19 14:41

【摘要】：目的探讨23 G前段玻璃体切割联合白内障超声乳化手术治疗浅前房低角膜内皮细胞密度(endothelial cell density,ECD)白内障的疗效及安全性。方法根据患者自愿原则,将2012年1月至2015年12月在郑州大学第二附属医院接受手术治疗的30例(34眼)ECD1000 mm-2的浅前房白内障患者分为联合手术组和Phaco组。联合手术组16例(19眼),行23 G前段玻璃体切割联合白内障超声乳化术;Phaco组14例(15眼),行单纯白内障超声乳化术。术后1 d、1周及3个月检查两组患者最佳矫正视力、角膜水肿程度,同时记录术前及术后3个月ECD,观察角膜水肿消退时间、术中及术后并发症。结果术后1 d,联合手术组最佳矫正视力较术前显著增高,差异有统计学意义(P0.05)。术后1周及3个月,两组最佳矫正视力均较术前显著增高,差异均有统计学意义(均为P0.05)。术后1 d及1周,联合手术组最佳矫正视力均优于Phaco组,差异均有统计学意义(均为P0.05)。术后1 d,联合手术组以1级角膜水肿为主,Phaco组以2级角膜水肿为主,两组角膜水肿程度差异有统计学意义(P0.05)。联合手术组角膜水肿平均消退时间为1.0 d,小于Phaco组的4.0 d,差异有统计学意义(P0.05)。术后3个月,联合手术组角膜内皮细胞丢失率为(7.86±0.76)%,低于Phaco组的(13.39±0.47)%,差异有统计学意义(P0.05)。结论23 G前段玻璃体切割联合白内障超声乳化术安全性好,角膜内皮细胞损伤小,术后角膜水肿轻,早期视力恢复快,适用于浅前房低ECD白内障患者。
[Abstract]:Objective to evaluate the efficacy and safety of 23 G anterior vitrectomy combined with phacoemulsification in the treatment of low corneal endothelial cell density (endothelial cell density,ECD) cataract in shallow anterior chamber. Methods from January 2012 to December 2015, 30 patients (34 eyes) with shallow anterior chamber cataract with ECD1000 mm-2 received surgical treatment from January 2012 to December 2015 in the second affiliated Hospital of Zhengzhou University were divided into combined operation group and Phaco group. 16 cases (19 eyes) in combined operation group were treated with 23 G anterior vitrectomy combined with phacoemulsification, and 14 cases (15 eyes) in Phaco group were treated with phacoemulsification. The best corrected visual acuity (BCVA) and corneal edema degree were examined 1 week and 3 months after operation. The time of corneal edema regression, intraoperative and postoperative complications were recorded by ECD, before and 3 months after operation. Results on the 1st day after operation, the best corrected visual acuity in the combined operation group was significantly higher than that in the preoperative group (P0.05). At 1 week and 3 months after operation, the best corrected visual acuity (BCVA) in both groups was significantly higher than that before operation (P0.05). The best corrected visual acuity of the combined operation group was better than that of the Phaco group on the 1st day and 1 week after operation, and the difference was statistically significant (P0.05). One day after operation, the corneal edema was mainly grade 1 in the combined operation group and the second grade in the Phaco group. There was significant difference in the degree of corneal edema between the two groups (P0.05). The mean extinction time of corneal edema in the combined operation group was 1.0 days, which was less than that in the Phaco group (P 0.05). The loss rate of corneal endothelial cells in the combined operation group was (7.86 卤0.76)%, lower than that in the Phaco group (13.39 卤0.47)%, the difference was statistically significant (P0.05). Conclusion 23 G anterior vitrectomy combined with phacoemulsification is safe, with little corneal endothelial cell damage, slight corneal edema and rapid recovery of early visual acuity. It is suitable for patients with shallow anterior chamber and low ECD cataract.
【作者单位】：郑州大学第二附属医院眼科;
【分类号】：R779.6

【相似文献】