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白内障手术中使用连续环形撕囊或精准脉冲截囊术后的内皮细胞丢失

Endothelial Cell Loss Following Cataract Surgery Using Continuous Curvilinear Capsulorhexis or Precision Pulse Capsulotomy.

作者信息

Vital Mark C, Jong Kevin Y, Trinh Clarise E, Starck Tomy, Sretavan David

机构信息

Houston Eye Associates, Houston, TX, USA.

UltraVision, San Antonio, TX, USA.

出版信息

Clin Ophthalmol. 2023 Jun 16;17:1701-1708. doi: 10.2147/OPTH.S411454. eCollection 2023.

DOI:10.2147/OPTH.S411454
PMID:37346471
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10281278/
Abstract

PURPOSE

To compare endothelial cell density (ECD), percentage of hexagonal cells (%Hex) and coefficient of variation (CV) in cell size following lens cataract surgery with phacoemulsification performed using Continuous Curvilinear Capsulorhexis (CCC) or Precision Pulse Capsulotomy (PPC).

PATIENTS AND METHODS

Sixty-seven subjects were randomly assigned to undergo lens cataract removal with the capsulotomy step performed using either CCC or PPC. Specular microscopy images were obtained pre-operatively, 1 month and 3 months after surgery. ECD, %Hex and CV were analyzed in a masked fashion by an independent reading center.

RESULTS

The mean percentage ECD loss at 1 month was 11.5% in the CCC group and 12.3% in the PPC group (P = 0.818; -test). At 3 months, the mean percentage ECD loss was 11.7% in the CCC group and 12.4% in the PPC group (P = 0.815; -test). The mean %Hex at 1 month was 54.3% in the CCC group and 54.7% in the PPC group (P = 0.695; -test). At 3 months, the mean %Hex was 56.2% in the CCC group and 54.7% in the PPC group (P = 0.278; -test). The CV at 1 month was 34.4% in the CCC group and 34.3% in the PPC group (P = 0.927; -test). At 3 months, the CV was 32.7% in the CCC group and 33.4% in the PPC group (P = 0.864; -test).

CONCLUSION

No differences in ECD loss, %Hex and CV were observed between patients who received CCC or PPC. PPC use during cataract surgery does not result in any increased endothelial cell loss beyond that normally associated with this surgery.

摘要

目的

比较采用连续环形撕囊术(CCC)或精准脉冲截囊术(PPC)进行白内障超声乳化手术后内皮细胞密度(ECD)、六边形细胞百分比(%Hex)以及细胞大小变异系数(CV)。

患者与方法

67名受试者被随机分配接受白内障摘除术,其中撕囊步骤分别采用CCC或PPC。术前、术后1个月和3个月获取镜面显微镜图像。由独立阅片中心以盲法分析ECD、%Hex和CV。

结果

CCC组1个月时ECD平均损失百分比为11.5%,PPC组为12.3%(P = 0.818;t检验)。3个月时,CCC组ECD平均损失百分比为11.7%,PPC组为12.4%(P = 0.815;t检验)。CCC组1个月时平均%Hex为54.3%,PPC组为54.7%(P = 0.695;t检验)。3个月时,CCC组平均%Hex为56.2%,PPC组为54.7%(P = 0.278;t检验)。CCC组1个月时CV为34.4%,PPC组为34.3%(P = 0.927;t检验)。3个月时,CCC组CV为32.7%,PPC组为33.4%(P = 0.864;t检验)。

结论

接受CCC或PPC的患者在ECD损失、%Hex和CV方面未观察到差异。白内障手术中使用PPC不会导致内皮细胞损失超过该手术通常伴随的损失。

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2
Femtosecond Laser-Assisted Cataract Surgery: A Report by the American Academy of Ophthalmology.飞秒激光辅助白内障手术:美国眼科学会报告。
Ophthalmology. 2022 Aug;129(8):946-954. doi: 10.1016/j.ophtha.2022.04.003. Epub 2022 May 13.
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The corneal endothelium: clinical review of endothelial cell health and function.角膜内皮:内皮细胞健康与功能的临床综述。
J Cataract Refract Surg. 2021 Sep 1;47(9):1218-1226. doi: 10.1097/j.jcrs.0000000000000650.
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