Dick H B, Kohnen T, Jacobi F K, Jacobi K W
Department of Ophthalmology, Justus-Liebig-University of Giessen, Germany.
J Cataract Refract Surg. 1996 Jan-Feb;22(1):63-71. doi: 10.1016/s0886-3350(96)80272-0.
To evaluate central endothelial cell loss (ECL) following clear corneal cataract surgery using two different incision sizes and the effect of ultrasound time (UST) and power on postoperative ECL and various cell parameters.
Fifty-eight patients had phacoemulsification through temporal, two-step clear corneal tunnel incisions. In Group A (n = 28), a one-piece, plate-haptic foldable silicone intraocular lens (IOL) was implanted through a 3.5 mm sutureless incision. In Group B (n = 30), a poly(methyl methacrylate) IOL was implanted through a 5.0 mm incision with one radial suture. The central endothelial cell counts were recorded preoperatively and postoperatively at 2 to 5 days, after 6 months, and after 1 year. Color-coded, computer-assisted specular microscopy was used for special cell analysis after 1 year.
Collective data showed an ECL of 7.9 +/- 4.1% (mean +/- standard deviation) at 2 to 5 days postoperatively, 6.7 +/- 2.9% after 6 months, and 7.3 +/- 3.3% after 1 year. A direct linear relationship was found between ECL and UST and power: ECL increased as UST and power increased. After 1 year, ECL in Group A was 4.2% with UST < or = 11/2 minutes, 6.7% with UST > 11/2 to 21/2 min, and 9.6% with UST > 21/2 to 31/2 min; in Group B it was 6.0%, 7.5%, and 11.4%, respectively. Specular microscopy showed normal, age-related cell parameters 1 year postoperatively.
Phacoemulsification with 3.5 mm clear corneal incisions produced slightly less ECL (6.7%) than phacoemulsification with 5.0 mm incisions (7.9%). Total ECL of 7.3% at 1 year postoperatively compared favorably with ECL rates of other cataract extraction methods.
采用两种不同切口大小评估透明角膜白内障手术后中央内皮细胞丢失（ECL）情况，以及超声时间（UST）和功率对术后ECL及各种细胞参数的影响。
58例患者经颞侧两步透明角膜隧道切口行超声乳化白内障吸除术。A组（n = 28）通过3.5mm无缝线切口植入一片式、板襻可折叠硅酮人工晶状体（IOL）。B组（n = 30）通过5.0mm切口并缝合一根放射状缝线植入聚甲基丙烯酸甲酯IOL。术前、术后2至5天、6个月后及1年后记录中央内皮细胞计数。术后1年采用彩色编码计算机辅助镜面显微镜进行特殊细胞分析。
汇总数据显示术后2至5天ECL为7.9±4.1%（平均值±标准差），6个月后为6.7±2.9%，1年后为7.3±3.3%。发现ECL与UST和功率之间存在直接线性关系：ECL随UST和功率增加而增加。1年后，A组UST≤1.5分钟时ECL为4.2%，UST＞1.5至2.5分钟时为6.7%，UST＞2.5至3.5分钟时为9.6%；B组分别为6.0%、7.5%和11.4%。镜面显微镜检查显示术后1年细胞参数正常，与年龄相关。
3.5mm透明角膜切口的超声乳化白内障吸除术产生的ECL（6.7%）略低于5.0mm切口的超声乳化白内障吸除术（7.9%）。术后1年总ECL为7.3%，与其他白内障摘除方法的ECL率相比具有优势。
