非超声乳化白内障手术对角膜内皮细胞核分裂影响的分析

[Analysis of the Effect of Non-phacoemulsification Cataract Operation on Corneal Endothelial Cell Nucleus Division].

作者信息

Huang Zufeng, Miao Xiaoqing

出版信息

Eye Sci. 2015 Sep;30(3):106-9.

Abstract

PURPOSE

To investigate the effect of non-phacoemulsification cataract operation in two different patterns of nucleus delivery on the quantity and morphology of corneal endothelial cells and postoperative visual acuity.

METHODS

Forty patients diagnosed with cataract underwent cataract surgery and were assigned into the direct nuclear delivery and semi-nuclear delivery groups. Lens density was measured and divided into the hard and soft lenses according to Emery-little lens nucleus grading system. Non-phacoemulsification cataract operation was performed. At 3 d after surgery, the quantity and morphology of corneal endothelium were counted and observed under corneal endothelial microscope. During 3-month postoperative follow-up, the endothelial cell loss rate, morphological changes and visual acuity were compared among four groups.

RESULTS

Corneal endothelial cell loss rate in the direct delivery of hard nucleus group significantly differed from those in the other three groups before and 3 months after operation (P < 0.01), whereas no statistical significance was found among the direct delivery of soft nucleus, semi-delivery of hard nucleus and semi-delivery soft nucleus groups (all P > 0.05). Preoperative and postoperative 2-d visual acuity did not differ between the semi-delivery of hard nucleus and direct delivery of soft nucleus groups (P = 0.49), significantly differed from those in the semi-delivery of soft nucleus (P = 0.03) and direct delivery of hard nucleus groups (P = 0.14). Visual acuity at postoperative four months did not differ among four groups (P = 0.067).

CONCLUSION

During non-phacoemulsification cataract surgery, direct delivery of hard nucleus caused severe injury to corneal endothelium and semi-delivery of soft nucleus yielded mild corneal endothelial injury. Slight corneal endothelial injury exerted no apparent effect upon visual acuity and corneal endothelial morphology at three months after surgery.

摘要

目的

探讨非超声乳化白内障手术中两种不同核娩出方式对角膜内皮细胞数量、形态及术后视力的影响。

方法

40例白内障患者接受白内障手术，分为直接娩核组和半娩核组。测量晶状体密度，并根据Emery-Little晶状体核分级系统分为硬核和软核。行非超声乳化白内障手术。术后3天，在角膜内皮显微镜下计数并观察角膜内皮的数量和形态。术后3个月随访期间，比较四组的内皮细胞丢失率、形态变化及视力。

结果

硬核直接娩出组角膜内皮细胞丢失率在手术前及术后3个月与其他三组相比差异有统计学意义（P<0.01），而软核直接娩出组、硬核半娩出组和软核半娩出组之间差异无统计学意义（均P>0.05）。硬核半娩出组与软核直接娩出组术前及术后2天视力差异无统计学意义（P=0.49），与软核半娩出组（P=0.03）和硬核直接娩出组（P=0.14）相比差异有统计学意义。术后4个月四组视力差异无统计学意义（P=0.067）。