标准同轴晶状体乳化与微小切口白内障手术:一项角膜内皮的研究

目的:评估新的微小切口白内障手术(MICS)是否较标准同轴晶状体乳化引起较少的内皮损害方法:年龄相关性白内障患者 200 例随机分配接受标准同轴晶状体乳化(SCP)或 MICS 晶状体乳化。术前及术后1a 测量角膜中央及 12 点内皮细胞计数、细胞大小变异系数、六角形细胞百分比以及角膜中央厚度。结果:患者 173 例完成了试验。在 1a 的随访检查中,MICS 组内皮细胞损失为 6.5204%,而 SCP 组为 8.726%(P<0.00005)。两组在细胞大小变异系数、六角形细胞百分比、术后角膜厚度以及在切口部位和角膜中央测得的内皮细胞密度变异方面无显著差异。在硬性白内障患者中,与手术步骤无关,内皮细胞密度损失的增加量较高。结论:比较 SCP 与 MICS,本研究表明后者引起的内皮细胞密度损失明显地较低。

Standard coaxial phaco vs. microincision cataract surgery: a corneal endothelium study

AIM: To assess whether the new microincision cataract surgery (MICS) induces less endothelium damages than the standard coaxial phacoemulsification.METHODS: Two hundred consecutive patients affected by age-related cataract were randomly assigned to undergo phacoemulsification using either standard coaxial phaco (SCP) or MICS. Central cornea and 12 o'clock endothelial cell count,cell size variation coefficient, percentage of hexagonality and central cornea thickness were measured before and up to one year after surgery.RESULTS: One hundred and seventy-three patients completed the trial. At the one-year follow-up visit, the loss of endothelium cells was 6.5204% in the MICS group and 8.726% in the SCP group (P＜0.00005). There was no significant differences between the two groups in terms of coefficient of variation in cell size, percentage of hexagonal cells,corneal thickness the day after surgery and variation of endothelial cell density measured both at the incision site and at the central cornea. In patients with hard cataracts, the increase in endothelial cell density loss was higher independently of the procedure.CONCLUSION: MICS induced a significant lower endothelial cell density loss than SCP.