玻璃体切割联合白内障手术治疗糖尿病视网膜病变对角膜内皮细胞的影响

发布时间：2018-03-02 01:06

本文关键词： 玻璃体切割超声乳化角膜内皮细胞糖尿病　出处：《中国医科大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的探讨玻璃体切割联合超声乳化白内障摘除并囊袋内植入折叠人工晶体手术治疗增殖期糖尿病性视网膜病变对角膜内皮细胞的影响。方法合适的选择增殖期糖尿病视网膜病变合并白内障的病例行玻璃体切割联合超声乳化白内障摘除手术并囊袋内植入折叠型人工晶体,分别于手术前,术后1周,术后3个月以上不同时期采集术眼角膜内皮细胞的各项分析指标,从中分析手术对角膜内皮细胞的影响及相关因素。并同时比较行玻璃体切割联合超声乳化白内障摘除术后的角膜内皮细胞的改变,单纯玻璃体切割术后的角膜内皮细胞的改变及单纯超声乳化白内障手术后角膜内皮细胞的改变,从中评价糖尿病患者角膜内皮细胞的功能及手术安全性。结果从2009年1月至2010年1月间收集糖尿病患着联合手术病例23例,糖尿病患者单纯超声乳化白内障手术25例,单纯玻璃体切割糖尿病患者29例,分别随诊3个月以上。分别比较各组不同时间角膜内皮细胞密度的变化,同时比较各组间的差异,统计患者未排除玻璃体充填的病例。结果发现：组内比较单纯玻璃体切割手术组手术前后各期角膜内皮细胞密度差异不明显,超声乳化组及联合手术组手术前后有显著性差异；各组间比较超声乳化组及联合手术组无显著差异,而两者与单纯玻璃体切割组比较差异明显。结论选择性的采用玻璃体切割联合超声乳化白内障摘除手术并植入人工晶体治疗增殖期糖尿病性视网膜病变伴有白内障的手术是有效的,对于角膜内皮细胞有一定的影响,但是联合手术与单纯超声乳化白内障手术比较并无显著性差异,这种手术方式是安全的。
[Abstract]:Purpose. To investigate the effect of vitrectomy combined with phacoemulsification and foldable intraocular lens implantation in the treatment of proliferative diabetic retinopathy on corneal endothelial cells. Method. Vitrectomy combined with phacoemulsification was performed in proliferative diabetic retinopathy with cataract, and foldable intraocular lens was implanted in the capsular bag before and 1 week after surgery. The analysis indexes of corneal endothelial cells were collected at different time after operation more than 3 months after operation. At the same time, the changes of corneal endothelial cells after vitrectomy and phacoemulsification were compared. The changes of corneal endothelial cells after vitrectomy and the changes of corneal endothelial cells after phacoemulsification were used to evaluate the function and safety of diabetic corneal endothelial cells. Results. From January 2009 to January 2010, 23 cases of diabetic patients underwent combined surgery, 25 cases of diabetic patients underwent phacoemulsification cataract surgery and 29 cases of simple vitrectomy diabetes mellitus. The changes of corneal endothelial cell density at different time and the difference of corneal endothelial cell density in each group were compared with each other for more than 3 months. The results showed that there was no significant difference in the density of corneal endothelial cells between the two groups before and after the operation, but there was significant difference between the phacoemulsification group and the combined operation group before and after the operation. There was no significant difference between the phacoemulsification group and the combined operation group, but there was a significant difference between the phacoemulsification group and the vitrectomy group. Conclusion. Selective vitrectomy combined with phacoemulsification and intraocular lens implantation in the treatment of proliferative diabetic retinopathy with cataract is effective and has a certain effect on corneal endothelial cells. But there was no significant difference between combined surgery and phacoemulsification alone.
【学位授予单位】：中国医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.6

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