Orski Michał, Synder Aleksandra, Pałenga-Pydyn Dorota, Omulecki Wojciech, Wilczyński Michał
Klin Oczna. 2014;116(2):94-9.
Corneal endothelium is a single layer of cells, which do not regenerate. Damage to the endothelium can take place in the course of certain diseases and after intraocular operations. When the number of endothelial cells decreases, corneal decompensation can occur. Pre- and postoperative measurement of the number of the corneal endothelial cells can help assess the degree of corneal damage during the surgery.
To compare the effect of various factors, such as: sex, age, corneal incision, intraocular pressure, cataract density, visual acuity and surgeon's experience on corneal endothelial cell loss following uneventful phacoemulsification.
365 patients (114 men and 251 women aged 19 to 91 years) undergoing phacoemulsification were examined preoperatively and postoperatively at 4 weeks. 68 eyes underwent phacoemulsification through a 1.8 mm microincision and 297 eyes through a standard 2.75 mm incision. Patients were operated on by four surgeons.
There was a significant difference in the postoperative endothelial cell loss relative to the degree of cataract hardness (p < 0.001). Endothelial cell loss was significantly higher in patients aged 71 and above than in the remaining age groups. Significant differences in the postoperative endothelial cell loss were observed in relation to the clear corneal incision size (p < 0.01). Preoperative best corrected visual acuity influenced the postoperative endothelial cell loss in a statistically significant way (p < 0.05). Endothelial cell loss was strongly influenced by the surgeon's experience.
Surgeon's experience, hardness of cataract, type of corneal incision, age and preoperative visual acuity influenced endothelial cell loss at 4 weeks following uneventful phacoemulsification, however such factors as sex and intraocular pressure showed no statistically significant influence on corneal endothelial cell loss.
角膜内皮是单层细胞，不会再生。内皮损伤可发生在某些疾病过程中及眼内手术后。当内皮细胞数量减少时，可发生角膜失代偿。术前和术后测量角膜内皮细胞数量有助于评估手术期间角膜损伤程度。
比较各种因素，如性别、年龄、角膜切口、眼压、白内障密度、视力和手术医生经验对顺利进行超声乳化术后角膜内皮细胞丢失的影响。
对365例（114例男性和251例女性，年龄19至91岁）接受超声乳化手术的患者在术前及术后4周进行检查。68只眼通过1.8mm微小切口进行超声乳化，297只眼通过标准2.75mm切口进行。患者由四位手术医生进行手术。
术后内皮细胞丢失与白内障硬度程度存在显著差异（p<0.001）。71岁及以上患者的内皮细胞丢失明显高于其他年龄组。观察到术后内皮细胞丢失与透明角膜切口大小存在显著差异（p<0.01）。术前最佳矫正视力对术后内皮细胞丢失有统计学上的显著影响（p<0.05）。内皮细胞丢失受手术医生经验的强烈影响。
手术医生经验、白内障硬度、角膜切口类型、年龄和术前视力影响顺利进行超声乳化术后4周的内皮细胞丢失，然而性别和眼压等因素对角膜内皮细胞丢失无统计学上的显著影响。
