Kiessling L A, Ernest P H, Lavery K T
J Cataract Refract Surg. 1993 Sep;19(5):610-2. doi: 10.1016/s0886-3350(13)80009-0.
We studied 40 eyes from patients with pre-existing corneal endothelial cell dystrophy (endothelial cell counts of less than or equal to 1,200/mm2) to assess whether the scleral tunnel incision with internal corneal lip and phacoemulsification in situ procedure affected the cornea. Identification of endothelial cell dystrophy by measuring preoperative endothelial cell counts was important so minor modifications of decreased phacoemulsification power and frequent viscoelastic endothelial coating could be made to prevent damage to the eyes. The procedures had no effect on corneal thickness or endothelial cell counts. Only about one fourth of the eyes studied (11) had more than 10% endothelial cell loss; none of the 11 eyes showed clinical evidence of corneal decompensation. All patients without other underlying pathologies such as macular degeneration attained postoperative visual acuity of at least 20/40. The scleral tunnel incision with internal corneal lip and phacoemulsification in situ procedure, with minor modifications, is safe in patients with endothelial cell dystrophy of the cornea.
我们研究了40只患有预先存在的角膜内皮细胞营养不良（内皮细胞计数小于或等于1200/mm²）患者的眼睛，以评估巩膜隧道切口联合角膜内唇及原位超声乳化手术是否会影响角膜。通过术前测量内皮细胞计数来识别内皮细胞营养不良很重要，这样可以对超声乳化能量降低和频繁进行粘弹剂内皮涂层等进行微小调整，以防止对眼睛造成损伤。这些手术对角膜厚度或内皮细胞计数没有影响。所研究的眼睛中只有约四分之一（11只）出现了超过10%的内皮细胞损失；这11只眼睛中没有一只出现角膜失代偿的临床证据。所有没有黄斑变性等其他潜在病变的患者术后视力至少达到20/40。巩膜隧道切口联合角膜内唇及原位超声乳化手术，经过微小调整后，对于角膜内皮细胞营养不良的患者是安全的。
