白内障超声乳化术的角膜内皮细胞观察.docxVIP

白内障超声乳化术的角膜内皮细胞观察厦门眼科中心 361001黎新 张铭志李东侃 吴秀宝【摘要】 目的 探讨白内障超声乳化术对角膜内皮细胞（CEC）的影响。 方法 采用颞上方透明角膜缘切口行白内障超声乳化术，平均超声能量及作用时间分别为23.8%、1分30秒；用非接触式角膜内皮细胞分析仪分别于术前、术后3—6个月拍摄174例（184只眼）角膜内皮细胞图像并进行计算机图像处理及自动分析 。 结果 手术前和术后3—6月的角膜内皮细胞密度分别为2531.8±345.3个/ mm2和2246.5±402.2个/ mm2，内皮细胞丧失率为11.6%。平均内皮细胞面积分别为331.13±125.25/μm2和385.21±198.32/μm2，变异系数分别为38.45%和48.63%，六角形细胞比率分别为52.6±12.9%和43.8±16.2%；与术前相比，术后角膜内皮细胞密度、六角形细胞比率减少，平均内皮细胞面积增大，统计学分析均有显著性差异（P 0.05 ）。术后6月矫正视力0.5以上者占88.6%，1.0以上者占50.0%。 结论 高龄或Ⅳ、Ⅴ级核的白内障患者施行白内障超声乳化术时，术前检查应常规行角膜内皮细胞计数分析，术中采用高负压、低超声能量操作，同样可以取得满意手术效果。【关键词】 白内障 超声乳化术 角膜内皮细胞分析仪 A clinical observation of corneal endothelial cells in phacoem ulsification Li xin zhang ming zhi li dong kan wu xiu bao Xia men eye centre 361001Objective:To investigate the effect of phacomulsification on corneal endothelium (CEC)Methods:Standard super-temporal incision phacoemulsification were applied to extract cataract on 184eyes(174cases) with a mean phaco-time of go seconds and a mean phaco-us of 23.8% Endothelium cell were observed with a none-contact endothelium-scope at pre-and3-6month post-operation.Results:Before surery and 3-6months after surgery. The average cell density of the cornealendotheliumwas2531.8±345.3cells/mm2and2246.5±402.2cells/mm2.respectively,the cellutar lost rate was 11.6%.the average cellularaca was 331.13±125.25um2.And 385.21 ±198.32um2 .The coefflcient of variation was38.45%and48.63%.The rate of heragonal cellwas52.6± 12.9%and43.8%±16.2%.The results showed that there were statistically significant difference (p0.05).6 month after surgery 88.6%of eyes attained correct vision of 0.5 or better and 50.0% of the eyes improved to 1.0 or better Conclusions:For senior cases and ⅣV nucleus cataract,endothelium Cell and its density must be observed if high vacuum and low phaco-us was followed satified result can also be achieved .Key words: Cataract Phacoemuls ification specular microscope 白内障超声乳化术因具有切口小、术后散光小、视力恢复快等特点，目前在临床上广泛应用于治疗白内障。但由于超声乳化探头每秒钟产生约四万次振动，其产生的热量及乳化颗粒的机械损伤不