糖尿病性白内障术后角膜内皮细胞的变化

目的研究糖尿病性白内障患者及合并高血压的糖尿病性白内障患者超声乳化术后角膜内皮细胞数量及形态学变化情况。方法随机选取行白内障手术的单纯老年性白内障患者40例(48眼)为对照组,糖尿病性白内障患者36例(42眼)为糖尿病组,以及合并高血压的糖尿病性白内障患者34例(44眼)为糖尿病合并高血压组;采用角膜内皮计对术前及术后1周、1个月角膜中央区的角膜内皮细胞进行计数,并观察角膜内皮细胞密度、细胞面积、六角形细胞百分比、变异系数变化情况。结果术前糖尿病组与对照组相比,六角形细胞比例均下降,细胞变异系数均增加,差异均有统计学意义(均为P<0.05),糖尿病合并高血压组六角形细胞比例进一步下降,变异系数进一步增加,与糖尿病组相比,差异亦均有统计学意义(均为P<0.05)。术后1周,糖尿病组角膜内皮细胞密度、细胞面积、六角形细胞比例、细胞变异系数分别为(2458.00±349.23)mm-2、(390.65±118.55)μm2、(46.18±9.24)%以及45.01±6.13,糖尿病合并高血压组分别为(2251.83±368.41)mm-2、(390.12±231.44)μm2、(42.73±8.75)%以及48.81±5.04,二者相比,六角形细胞比例和细胞变异系数间差异有统计学意义(均为P<0.05);术后1个月,糖尿病组和糖尿病合并高血压组六角形细胞比例均进一步降低,分别为(40.72±4.60)%和(36.91±7.35)%,细胞变异系数进一步增加,分别为50.55±9.25和55.25±9.83,两组相比差异均有统计学意义(均为P<0.05)。结论糖尿病性白内障患者角膜内皮细胞状况较单纯老年性白内障患者差;糖尿病性白内障患者以及合并高血压的糖尿病性白内障患者角膜内皮在超声乳化术中都更易受到损害。

Changes of corneal endothelial cells after diabetic cataract surgery

Objective To investigate the changes of number and morphology of corneal endothelial cells after phacoemulsification in diabetic cataract patients with or without hypertension.Methods Phacoemulsification were performed in 40 patients with senile cataract(48 eyes,control group),36 patients with diabetic cataract(42 eyes,diabetes group) and 34 patients with diabetic cataract and hypertension(44 eyes,hypertension group).The corneal endothelial cells before surgery,1 week and 1 month after surgery were counted,and the corneal endothelial cell density,average cell area,coefficient of variation(CV) and percentage of hexagonal cell were measured.Results Compared with control group,the preoperative percentage of hexagonal cell in diabetes group was decreased,CV was increased,there were statistical differences(both P<0.05).At postoperative 1 week,the corneal endothelial cell density,average cell area,percentage of hexagonal cell and CV in diabetes group were(2458.00±349.23)mm-2,(390.65±118.55)μm2,(46.18±9.24) % and 45.01±6.13,respectively,which in hypertension group were(2251.83±368.41)mm-2,(390.12±231.44)μm2,(42.73±8.75) % and 48.81±5.04,respectively,there were statistical differences in percentage of hexagonal cell and CV between two groups(both P<0.05).At postoperative 1 month,the percentage of hexagonal cell in diabetes group and hypertension group were further decreased,which were(40.72±4.60)% and(36.91±7.35)%,and CV were further increased,which were 50.55±9.25 and 55.25±9.83,there were statistical differences between two groups(both P<0.05).Conclusion The condition of the corneal endothelial cells in diabetic cataract patients is worse than that in senile cataract patients.The corneal endothelium of diabetic patients with or without hypertension is more prone to damage from phacoemulsification.