超声乳化治疗原发性闭角型青光眼对角膜内皮影响的临床观察

目的:探讨角膜内皮细胞密度在超声乳化白内障吸除术以及小梁切除术治疗原发性闭角型青光眼前后的变化。方法:原发性闭角型青光眼合并有白内障的患者133例随机分为两组,分别行超声乳化白内障吸除术和小梁切除术,应用美国Bio-optics LSM 22000接触型角膜内皮显微镜对两组患者术前及术后3mo角膜内皮细胞密度和面积等进行观察,结果进行统计学分析。结果:两组手术前后眼压均明显下降,比较有显著性差异(P<0.01)。超声乳化组手术前后角膜内皮细胞密度分别为2483±486个/mm2和2336±305个/mm2,小梁切除术组手术前后为2438±375个/mm2和2326±216个/mm2,两组手术前后比较无显著性差异。细胞周长、平均细胞面积、细胞多形性变异率联组比较无显著性差异,六角形细胞的百分数在浅前房的患者下降(P<0.05)。结论:超声乳化白内障吸除术治疗原发性闭角型青光眼是一种安全有效的手术方法。术前角膜内皮细胞密度的检查是很重要的。

Clinical study on corneal endothelial changes after phacoemulsification in eyes with primary angle-closure glaucoma

AIM: To compare the changes of corneal endothelial cell density before and after phacoemulsification and trabeculectomy treating the patients with primary angle-closure glaucoma. ·METHODS: Totally 133 patients with primary angle-closure glaucoma and coexisting cataract were randomly divided into two groups. Phacoemulsification and trabe-culectomy were performed respectively. The endothe-lium cell density, average cell area and percentage of hexagonal cell density were determined by Bio-optics LSM 22000 CS corneal specula microscope preoperatively and 3 months postoperatively. The endothelial images were analyzed by computer. ·RESULTS: There were significant differences in IOP reduction in two groups before and after surgery (P<0.01). The density of corneal endothelial cells changed from per mm2 2 483±486 to 2 336±305 in phaco group and from per mm2 2 458±375 to 2 326±216 in Trab group with no signifant differences. There were no significant differences in cell perimeter, average cell area, cell densi-ty, and polymegathism in two groups. The percentage of hexagonal cell density was decreased in patients with shallow anterior chamber (P<0.05). ·CONCLUSION: Phacoemulsification is a safe and effective treatment to PACG. It is important to check the density of corneal endothelial cells before surgery.