小儿白内障手术后中央角膜厚度和内皮细胞计数的变化

Changes in Central Corneal Thickness and Endothelial Cell Count Following Pediatric Cataract Surgery.

作者信息

Memon Mariya Nazish, Siddiqui Sorath Noorani

机构信息

Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, Sind.

Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi.

出版信息

J Coll Physicians Surg Pak. 2015 Nov;25(11):807-10.

PMID:26577966

Abstract

OBJECTIVE

To evaluate the mean changes in Central Corneal Thickness (CCT) and Endothelial Cell Count (ECC) in eyes after pediatric cataract surgery with foldable intraocular lens using scleral tunnel incision micro-surgical technique.

STUDY DESIGN

Qausi experimental study.

PLACE AND DURATION OF STUDY

Department of Pediatric Ophthalmology and Strabismus, Al-Shifa Trust Eye Hospital, Rawalpindi, from May 2011 to March 2012.

METHODOLOGY

Fifty-two eyes of 37 children with pediatric cataract were included in the study. Extracapsular Cataract Extraction (ECE) with foldable Intra Ocular Lens (IOL) implantation using sclera tunnel incision was performed in all children. Endothelial Cell Count (ECC) and Central Corneal Thickness (CCT) were recorded before surgery and 1 month, 3 months and 6 months after surgery and the effect of currently practiced surgical technique on ECC and CCT was evaluated.

RESULTS

The mean age at the time of surgery was 8.8 ±2.7 years (range: 4 to 15 years). The postoperative ECC and CCT were significantly different from the pre-operative values. Mean pre-operative ECC was 3175.3 ±218.4 cell/mm2 and in first postoperative month the mean ECC was 3113.4 ±210.8 cell/mm2(p<0.0001). In the 3rd and 6th month postoperative means ECC were 3052 ±202.5 cell/mm2(p<0.0001) and 3015 ±190.6 cell/mm2(p<0.0001), respectively. The mean cell loss at first postoperative month was 1.95% and at 3rd and 6th postoperative month were 3.9% and 5.05%, respectively. Mean pre-operative CCT was 514 ±49.9 µm and first postoperative mean CCT after 1 month was 524.1 ±25 µm (p = 0.084). After the 3rd and 6th months postoperative, mean CCT were 527.3 ±24.6 µm, and 530 ±24.5 µm, respectively. Third and 6th months postoperative means were significantly higher than baseline CCT, p = 0.024 and 0.007, respectively.

CONCLUSION

Endothelial cell loss with closed chamber micro-surgical technique using scleral tunnel incision is within acceptable limits and within the range of normal ECC in children.

摘要

目的

评估采用巩膜隧道切口显微手术技术植入可折叠人工晶状体的小儿白内障手术后眼睛中央角膜厚度（CCT）和内皮细胞计数（ECC）的平均变化。

研究设计

准实验研究。

研究地点和时间

2011年5月至2012年3月，拉瓦尔品第的阿尔 - 希法信托眼科医院小儿眼科与斜视科。

方法

37例小儿白内障患儿的52只眼睛纳入研究。所有患儿均采用巩膜隧道切口行白内障囊外摘除术（ECE）并植入可折叠人工晶状体（IOL）。记录手术前、术后1个月、3个月和6个月的内皮细胞计数（ECC）和中央角膜厚度（CCT），并评估当前手术技术对ECC和CCT的影响。

结果

手术时的平均年龄为8.8±2.7岁（范围：4至15岁）。术后ECC和CCT与术前值有显著差异。术前平均ECC为3175.3±218.4个细胞/mm²，术后第一个月平均ECC为3113.4±210.8个细胞/mm²（p<0.0001）。术后第3个月和第6个月的平均ECC分别为3052±202.5个细胞/mm²（p<0.0001）和3015±190.6个细胞/mm²（p<0.0001）。术后第一个月的平均细胞损失率为1.95%，术后第3个月和第6个月分别为3.9%和5.05%。术前平均CCT为514±49.9µm，术后1个月的首次平均CCT为524.1±25µm（p = 0.084）。术后第3个月和第6个月，平均CCT分别为527.3±24.6µm和530±24.5µm。术后第3个月和第6个月的平均值显著高于基线CCT，p分别为0.024和0.007。