低角膜内皮细胞密度患者行低灌注模式和低负压下超声乳化白内障吸除术的临床观察。
Clinical observation of phacoemulsification under the low perfusion pattern and low negative pressure in patients with low corneal endothelial cell density.
机构信息
Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
出版信息
BMC Ophthalmol. 2023 Jul 31;23(1):340. doi: 10.1186/s12886-023-03095-w.
BACKGROUND
To observe the safety and effect of phacoemulsification combined with intraocular lens (IOL) implantation in patients with low corneal endothelial cell density (CD) under the low perfusion pattern with low negative pressure.
METHODS
In this retrospective case series study, a total of 16 patients (17 eyes) were studied. They had all been diagnosed with low corneal endothelial (CD) and cataracts in the First Affiliated Hospital of Fujian Medical University from December 2019 to October 2021. They underwent phacoemulsification combined with IOL implantation under the low perfusion pattern with low negative pressure. The variations of corneal endothelial( CD), coefficient of variation (CV) of the cell area, central corneal thickness (CCT), visual acuity, and intraocular pressure before and after the operation were observed and assessed. Then a paired t-test, repeated measures analysis of variance, and Pearson correlation analysis were adopted for data analysis.
RESULTS
The mean intraocular pressure of the 17 eyes was 16.88 ± 6.47 mmHg before the operation and 14.41 ± 3.10 mmHg after the operation, showing a statistically significant difference of t = 2.222, and p = 0.041. Before the operation, the mean visual acuity was 0.16 ± 0.09, and after the operation, it was 0.45 ± 0.16, displaying a statistically significant difference of t = -9.917, p < 0.001. Before and after the operation, four of the 17 eyes had no detectable CD. The mean CD of the other 13 eyes at one month after the operation (644.308 ± 106.24 cells/mm) was lower than that before the operation (709.62 ± 119.19 cells/mm), and the differences were statistically significant (F = 20.044, p < 0.001). However, no statistically significant differences were found in the mean CV before the operation (31.23 ± 4.21), and at one month after the operation (32.62 ± 3.80; F = 2.130, p = 0.157). Moreover, the mean CCT of 14 eyes at one month after the operation (562.72 ± 27.82 μm) was larger than that before the operation (534.79 ± 24.69 μm).
CONCLUSIONS
The low perfusion pattern with low negative pressure is safe and effective for corneal endothelial dysfunction patients complicated with cataracts.
背景
观察低负压低灌注模式下超声乳化白内障吸除术联合人工晶状体植入术治疗低角膜内皮细胞密度（CD）患者的安全性和效果。
方法
本回顾性病例系列研究共纳入 16 例（17 只眼）于 2019 年 12 月至 2021 年 10 月在福建医科大学附属第一医院诊断为低角膜内皮（CD）合并白内障的患者。所有患者均在低负压低灌注模式下接受超声乳化白内障吸除术联合人工晶状体植入术。观察并评估手术前后角膜内皮（CD）、细胞面积变异系数（CV）、中央角膜厚度（CCT）、视力和眼内压的变化。采用配对 t 检验、重复测量方差分析和 Pearson 相关分析进行数据分析。
结果
17 只眼中手术前平均眼压为 16.88±6.47mmHg，手术后为 14.41±3.10mmHg，差异有统计学意义 t=2.222，p=0.041。手术前平均视力为 0.16±0.09，手术后为 0.45±0.16，差异有统计学意义 t=-9.917，p<0.001。术前，17 只眼中有 4 只眼无法检测到 CD。术后 1 个月，其余 13 只眼的平均 CD 值（644.308±106.24 个/mm）低于术前（709.62±119.19 个/mm），差异有统计学意义（F=20.044，p<0.001）。然而，术前平均 CV（31.23±4.21）和术后 1 个月时（32.62±3.80；F=2.130，p=0.157）差异无统计学意义。此外，术后 1 个月 14 只眼的平均 CCT（562.72±27.82μm）大于术前（534.79±24.69μm）。
结论
低负压低灌注模式对于合并白内障的角膜内皮功能障碍患者是安全有效的。
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