Zhu Li-Li, Zhu Bing-Xue, Han Yue, Tang Yong-Yan, Wen Ying-Ying, Zhang Xu-Hong, Zhang Li-Yue, Zhu Ri-Lei, Guo Dong-Yu
Department of Ophthalmology, First Affiliated Hospital of Zhejiang University, Hangzhou 310000, Zhejiang Province, China.
Department of Ophthalmology, People's Hospital of Haixi Autonomous Prefecture of Qinghai Province, Delingha 817000, Qinghai Province, China.
Int J Ophthalmol. 2025 Mar 18;18(3):409-414. doi: 10.18240/ijo.2025.03.06. eCollection 2025.
To compare analysis of the impact of high altitude on corneal endothelial cells, and the prognosis in patients with cataract surgeries.
Totally 265 plateau patients with cataract surgeries performed between January 2019 and July 2022 (average altitude=3000 m), and 524 plain patients with cataract surgeries performed between January 2020 and July 2022 were included. The propensity score matching (PSM) method was applied to match the basic information of patients in both regions on a 1:1 basis. Corneal endothelial cell density (ECD), coefficient of variation (CV), hexagonal cell ratio (HEX), duration of surgery, and pre- and postoperative visual acuity (VA) were compared retrospectively, and correlation tests were done.
Totally 223 pairs have been matched successfully. The HEX in the plateau group was higher than that in the plain group (61.95%±6.191% 44.91%±6.829%, <0.001). For ECD and CV, no significant differences were observed between both groups (>0.1). The pre- and postoperative VA of patients with cataract surgeries in the plateau group were lower (1.40±0.610 0.71±0.514, <0.001 & 0.68±0.479 0.18±0.259, <0.001), and the duration of surgery was longer than those in the plain group (27.06±14.900 min 16.03±8.033 min, <0.001). No significant associations were found between the post-operative VA and the corneal endothelial parameters (>0.05), while the post-operative VA was significantly related to the pre-operative VA and the duration of surgery (<0.05).
The relative hypoxic environment of the plateau does not promote the apoptosis of corneal endothelial cells, but may lead to the compensatory increase of their functions. In plateau patients, no significant associations are found between the poor VA and the corneal endothelial functions early after cataract surgeries.
比较分析高原环境对角膜内皮细胞的影响以及白内障手术患者的预后情况。
纳入2019年1月至2022年7月期间进行白内障手术的265例高原患者（平均海拔3000米）以及2020年1月至2022年7月期间进行白内障手术的524例平原患者。采用倾向评分匹配（PSM）方法按1:1比例匹配两个地区患者的基本信息。回顾性比较角膜内皮细胞密度（ECD）、变异系数（CV）、六角形细胞比例（HEX）、手术时长以及术前和术后视力（VA），并进行相关性检验。
共成功匹配223对。高原组的HEX高于平原组（61.95%±6.191% 对44.91%±6.829%，P<0.001）。对于ECD和CV，两组间未观察到显著差异（P>0.1）。高原组白内障手术患者的术前和术后VA较低（1.40±0.610对0.71±0.514，P<0.001；0.68±0.479对0.18±0.259，P<0.001），且手术时长比平原组更长（27.06±14.900分钟对16.03±8.033分钟，P<0.001）。术后VA与角膜内皮参数之间未发现显著关联（P>0.05），而术后VA与术前VA和手术时长显著相关（P<0.05）。
高原相对缺氧的环境不会促进角膜内皮细胞凋亡，但可能导致其功能的代偿性增加。在高原患者中，白内障手术后早期视力不佳与角膜内皮功能之间未发现显著关联。
