Ganekal Sunil, Nagarajappa Ashwini
Nayana Superspecialty Eye Hospital and Research Center, Davangere, Karnataka, India ; Department of Ophthalmology, Jayadeva Jagadguru Murugarajendra Medical College, Davangere, Karnataka, India.
Department of Ophthalmology, Jayadeva Jagadguru Murugarajendra Medical College, Davangere, Karnataka, India.
Middle East Afr J Ophthalmol. 2014 Jan-Mar;21(1):56-60. doi: 10.4103/0974-9233.124098.
To compare the morphological (cell density, coefficient of variation and standard deviation) and functional (central corneal thickness) endothelial changes after phacoemulsification versus manual small-incision cataract surgery (MSICS).
Prospective randomized control study.
In this prospective randomized control study, patients were randomly allocated to undergo phacoemulsification (Group 1, n = 100) or MSICS (Group 2, n = 100) using a random number Table. The patients underwent complete ophthalmic evaluation and specular microscopy preoperatively and at 1and 6 weeks postoperatively. Functional and morphological endothelial evaluation was Noncon ROBO PACHY SP-9000 specular microscope. Phacoemulsification was performed, the chop technique and MSICS, by the viscoexpression technique.
The mean difference in central corneal thickness at baseline and 1 week between Group 1 and Group 2 was statistically significant (P = 0.027). However, this difference at baseline when compared to 6 week and 1 week, 6 weeks was not statistically significant (P > 0.05). The difference in mean endothelial cell density between groups at 1 week and 6 weeks was statistically significant (P = 0.016). The mean coefficient of variation and mean standard deviation between groups were not statistically significant (P > 0.05, both comparisons).
The central corneal thickness, coefficient of variation, and standard deviation were maintained in both groups indicating that the function and morphology of endothelial cells was not affected despite an initial reduction in endothelial cell number in MSICS. Thus, MSICS remains a safe option in the developing world.
比较白内障超声乳化术与手动小切口白内障手术（MSICS）后形态学（细胞密度、变异系数和标准差）和功能性（中央角膜厚度）的内皮细胞变化。
前瞻性随机对照研究。
在这项前瞻性随机对照研究中，使用随机数字表将患者随机分配接受白内障超声乳化术（第1组，n = 100）或MSICS（第2组，n = 100）。患者在术前、术后1周和6周接受全面的眼科评估和镜面显微镜检查。功能性和形态学内皮细胞评估使用Noncon ROBO PACHY SP - 9000镜面显微镜。白内障超声乳化术采用劈核技术，MSICS采用粘弹剂挤压技术。
第1组和第2组在基线和术后1周时中央角膜厚度的平均差异具有统计学意义（P = 0.027）。然而，与术后6周相比，基线时的这种差异以及术后1周与6周之间的差异均无统计学意义（P > 0.05）。两组在术后1周和6周时平均内皮细胞密度的差异具有统计学意义（P = 0.016）。两组之间的平均变异系数和平均标准差无统计学意义（P > 0.05，两种比较均如此）。
两组的中央角膜厚度、变异系数和标准差均保持稳定，这表明尽管MSICS术后内皮细胞数量最初有所减少，但内皮细胞的功能和形态并未受到影响。因此，在发展中国家，MSICS仍然是一种安全的选择。
