双重粘弹剂在白内障超声乳化摘除术中的应用

目的：探讨双重粘弹剂（内聚性和弥散性）在白内障超声乳化摘除术中对角膜内皮的保护作用。方法：将91例（100眼）白内障分两类4组。第一类为硬核类（≥Ⅳ级核），22例24眼硬核白内障操作中应用双重粘弹剂作为观察组，20例20眼硬核白内障单纯应用内聚性粘弹剂作为对照组；第二类为非硬核类（≤Ⅲ级核），25例28眼非硬核白内障操作中应用双重粘弹剂作为观察组，24例28眼非硬核白内障单纯应用内聚性粘弹剂作为观察组。观察术后1天角膜水肿情况，术前及术后1个月角膜内皮细胞计数。结果：第一类观察组和对照组术后角膜水肿差异有统计学意义（P〈0．01），术前、术后角膜内皮丢失率无统计学意义（P〉0．05）；第二类观察组和对照组术后角膜水肿和术前、术后角膜内皮丢失均无统计学意义（P〉0．05）。结论：硬核白内障超声乳化术中应用双重粘弹剂，可以有效减少手术并发症，提高手术的安全性。

Use of bilviscoelastic materials in cataract endocapsular phacoemulsification

Objective：To Observe the role of bilviscoelastic materials （dispersive and cohesive）in protection of corneal endothelium in cataract endocapsular phacoemulcification. Methods： Two types of cataracts were divided into 4 groups. The first type was hard nuclear cataract （ ≥ Ⅳ grade） ：24 eyes of 22 cases using dispersive and cohesive viscoelastic materials in ndocapsular phacoemulcification served as study group and 20 eyes of 20 cases using only cohesive viscoelastic materials acted as control. The second type was soft nuclear cataract （ ≤Ⅲ grade ） ： 28 eyes of 25 cases using dispersive and cohesive viscoelastic materials in endocapsular phacoemulcification served as study group and 28 eyes of 24 cases using only ohesive viscoelastic materials acted as control. The corneal edema was observed one day after operation and the endothelial cell density was measured before operation and one month after operation. Results：There was statistically significant differences in corneal edema between the two groups in the first type （P 〈 0. 01 ） ; the difference was not statically different in the loss of corneal endothelium（ P 〉 0.05 ） ;there was no statistically significant differences between the two groups in the second type （ P 〉 0. 05 ）. Conclusions： Use of bilviscoelastic materials in hard nuclear cataract phacoemulcification could protect corneal endothelium and decrease coneal complications.