Cutolo Carlo Alberto, Bonzano Chiara, Catti Carlo, Bagnis Alessandro, Scotto Riccardo, Negri Letizia, Olivari Sara, Cappelli Francesca, Traverso Carlo Enrico
Clinica Oculistica, DiNOGMI, University of Genoa and IRCCS San Martino Policlinic Hospital, Genova, Italy.
J Ophthalmol. 2019 Jul 28;2019:6368784. doi: 10.1155/2019/6368784. eCollection 2019.
To investigate demographic and anatomical factors associated with a reduction in endothelial cell density (ECD) after phacoemulsification (PE) for the treatment of primary angle closure (PAC).
In this prospective case series, ECD was evaluated by noncontact specular microscopy and biometric parameters by both noncontact optical biometry and anterior segment optical coherence tomography, preoperatively and at 12 months after surgery. Anterior segment biomicroscopy and gonioscopy were also performed. The change in ECD and its relation to clinical characteristics and biometric parameters were evaluated by linear regression analysis.
44 patients with PAC were included in the study. The mean (SD) patient age was 71.6 (10.2) years; thirty-one (70.5%) of them were women. Coexistence of exfoliation syndrome (XS) was observed in 4 cases (9.1%). The mean (SD) ECD (cells/mm) changed from 2275 (463) preoperatively to 1964 (613) postoperatively with a mean reduction of -310 (95% CI -445 to -176; < 0.001). In the multivariate regression model, after correction for age and lens status, XS was the only parameter associated with ECD percentage change ( = -36.00; =0.001).
PE in angle closure causes a significant ECD reduction. In our population of PAC patients, XS is significantly associated with ECD change. In this group of patients, a careful preoperative endothelial evaluation should be performed.
研究与原发性闭角型青光眼（PAC）行超声乳化白内障吸除术（PE）后内皮细胞密度（ECD）降低相关的人口统计学和解剖学因素。
在这个前瞻性病例系列中，术前及术后12个月通过非接触式镜面显微镜评估ECD，通过非接触式光学生物测量法和眼前节光学相干断层扫描评估生物测量参数。还进行了眼前节生物显微镜检查和前房角镜检查。通过线性回归分析评估ECD的变化及其与临床特征和生物测量参数的关系。
44例PAC患者纳入研究。患者平均（标准差）年龄为71.6（10.2）岁；其中31例（70.5%）为女性。4例（9.1%）观察到存在剥脱综合征（XS）。ECD平均（标准差）（细胞/mm²）从术前的2275（463）降至术后的1964（613），平均降低-310（95%CI -445至-176；P<0.001）。在多变量回归模型中，校正年龄和晶状体状态后，XS是与ECD百分比变化相关的唯一参数（β=-36.00；P=0.001）。
闭角型青光眼行PE会导致ECD显著降低。在我们的PAC患者群体中，XS与ECD变化显著相关。对于该组患者，应进行仔细的术前内皮评估。
