飞秒激光辅助白内障超声乳化术后角膜内皮的改变

Abstract

目的：探讨飞秒激光辅助白内障超声乳化术与超声乳化术治疗白内障对角膜内皮的影响，分析比较两种手术方式术后角膜内皮细胞的改变特点。方法：分析我院2017年1月~2018年1月收治的白内障患者86例(100眼)，其中A组46例(50眼)行飞秒激光辅助白内障超声乳化术，B组40例(50眼)行白内障超声乳化术，用角膜内皮镜分别观察患者术前、术后1周、术后1个月、术后3个月的中央区角膜内皮细胞密度、六角形细胞比例、平均细胞面积及角膜内皮丢失率。结果：术后两组中央区角膜内皮细胞密度和六角形细胞比例均较术前降低，平均细胞面积较术前增大；两组术后1周、术后1个月、术后3个月的中央区角膜内皮细胞密度、六角形细胞比例、平均细胞面积与术前相比差异有统计学意义(P < 0.05)，术后相同时间点平均细胞面积及角膜内皮丢失率B组均大于A组、六角形细胞比例B组均小于A组，差异有统计学意义(P < 0.05)。结论：飞秒激光辅助白内障超声乳化术对角膜内皮的损伤更小，是一种较为安全的手术方式。 Objective: To evaluate the efficacy of corneal endothelial cell after femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery, and compare the changes after two cataract surgery. Methods: Clinical data in our hospital from January 2017 to January 2018, which treated 86 cases (100 eyes) of cataract patients, were divided into two groups according to different types of operation. A group includes 46 cases (50 eyes), underwent femtosecond laser assisted cataract surgery; in the B group, 40 cases (50 eyes), underwent the conventional phacoemulsification cataract surgery. Corneal endothelial cell density, mean cell area, proportion of hexagonal cells and cell loss rate were observed preoperatively and 1 week, 1 month, 3 months postoperatively for the two groups. Results: After the operation, the endothelial cell density and the proportion of hexagonal cells of the two groups all decreased, and mean cell area increased. The difference of corneal endothelial cell density, mean cell area, proportion of hexagonal cells, between before and after operation, was statistically significant, in the same time after operation, cell loss rate in group B was bigger than those in group A, the proportion of hexagonal cells in group B was smaller than those in group A. Conclusions: Femtosecond laser-assisted cataract surgery has a lower damage to corneal endothelial cell, and was a safe operation method.