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采用超声乳化劈核技术的糖尿病和非糖尿病眼在白内障超声乳化术中内皮细胞密度的变化。

Endothelial cell density changes in diabetic and nondiabetic eyes undergoing phacoemulsification employing phaco-chop technique.

作者信息

Fernández-Muñoz Erika, Zamora-Ortiz Rocío, Gonzalez-Salinas Roberto

机构信息

Anterior Segment Surgery Department, Asociación para Evitar la Ceguera, Mexico City, Mexico.

Research Department, Asociación para Evitar la Ceguera, Vicente García Torres 46, Barrio San Lucas, Coyoacán, CP 04030, Mexico City, Mexico.

出版信息

Int Ophthalmol. 2019 Aug;39(8):1735-1741. doi: 10.1007/s10792-018-0995-y. Epub 2018 Jul 28.

Abstract

PURPOSE

To assess endothelial cell density (ECD) changes on diabetic and nondiabetic patients after phacoemulsification surgery employing the phaco-chop technique.

METHODS

This is a prospective, experimental and comparative study. We included type-two diabetic (T2DM) patients and nondiabetic patients who underwent phacoemulsification performed by a single surgeon employing the horizontal phaco-chop technique. ECD and central corneal thickness (CCT), the coefficient of variation and percentage of polymegathism were measured and compared. Specular microscopy was used to evaluate the number of endothelial cells in patients during surgical pre-assessment and at the 1- and 3-month follow-up visits.

RESULTS

A total of 42 eyes from 42 patients were included: 21 eyes in the T2DM group and 21 eyes in the nondiabetic group. No statistically significant differences were found between groups in terms of age and sex distribution (p = 0.296; p = 0.502, respectively). Mean postoperative (at 1 and 3-month follow-up) endothelial cell count of the T2DM group was not significantly lower than the nondiabetic group (p = 0.341 and p = 0.065, respectively). Postoperative CCT measurements demonstrated no significant variations between groups, showing a mean 557.8 ± 48.0 and 543.3 ± 41.0 μm, respectively (p = 0.472). Nonetheless, significant differences were evidenced for CoV values for both the pre-surgical and the postoperative follow-up visits between groups, as well as ECD values inside each group.

CONCLUSIONS

The present study reveals significant differences between pre-surgical and postoperative mean ECD values; however, no statistically significant differences were found when comparing ECD at each follow-up visit between diabetic patients without evidence of high-risk proliferative diabetic retinopathy and nondiabetic patients undergoing phacoemulsification employing phaco-chop technique.

摘要

目的

采用超声乳化劈核技术评估糖尿病患者和非糖尿病患者白内障超声乳化术后内皮细胞密度(ECD)的变化。

方法

这是一项前瞻性、实验性和对比性研究。我们纳入了由同一位外科医生采用水平超声乳化劈核技术进行白内障超声乳化手术的2型糖尿病(T2DM)患者和非糖尿病患者。测量并比较ECD、中央角膜厚度(CCT)、变异系数和多形性百分比。在手术前评估以及术后1个月和3个月随访时,使用镜面显微镜评估患者的内皮细胞数量。

结果

共纳入42例患者的42只眼:T2DM组21只眼,非糖尿病组21只眼。两组在年龄和性别分布方面无统计学显著差异(分别为p = 0.296;p = 0.502)。T2DM组术后(术后1个月和3个月随访时)的平均内皮细胞计数并不显著低于非糖尿病组(分别为p = 0.341和p = 0.065)。术后CCT测量显示两组之间无显著差异,平均分别为557.8±48.0和543.3±41.0μm(p = 0.472)。然而,两组术前和术后随访的变异系数值以及每组内的ECD值均存在显著差异。

结论

本研究揭示了术前和术后平均ECD值之间存在显著差异;然而,在比较无高危增殖性糖尿病视网膜病变证据的糖尿病患者与采用超声乳化劈核技术进行白内障超声乳化手术的非糖尿病患者每次随访时的ECD时,未发现统计学显著差异。

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