超声乳化白内障吸除人工晶体植入术角膜内皮损伤分析

目的观察超声乳化白内障吸除术中精确控制超声能量对提高乳化效率，减少角膜内皮损伤并发症的作用。方法随机抽取行超声乳化白内障吸除联合人工晶体植入术患者50例53眼，对其术前术后角膜内皮细胞情况进行观察。结果内皮细胞密度为每平方毫米15003400个，平均每平方毫米（2075．00±555．47）个，细胞形态均在正常范围内，六边形细胞百分率为（69．98±5．75）％。术后1周角膜内皮细胞密度变化为每平方毫米1300-3400个，平均每平方毫米（2500．00±500．05）个：内皮细胞丢失率为7．92％，手术前后角膜内皮细胞之间的密度差异有统计学意义（P〈0．01）。术后角膜内皮细胞形态发生了改变，有轻、重度内皮细胞扩大及多形细胞的增多，并可见空穴。六边形细胞百分率为（53．76±8．26）％，丢失率为15．13％，手术前后的差异有统计学意义（P〈0．01）。结论超声乳化白内障吸除术中对角膜内皮的损伤因素是多方面的，除人工晶体的质量外，还与前房黏弹剂的应用、术中灌注液、手术器械的消毒等有关。手术对角膜内皮的损伤在多环节中发生，手术技巧的提高可明显减少角膜内皮细胞的损伤。

Annanysis on the energy efficiency improvment and the corneal endothelial emulsion injury

Objective To observe the energy efficiency improvement and the corneal endothelial emulsion injury complications reduced by precise control of intraoperative ultrasound in phacoemulsification and intraovular lens implantation in cataract.Methods Take 53 eyes in 50 cases of patients at random,and their preoperative and postoperative corneal endothelial cells were observed.Results Endothelial cell density of the 53 observed eyes was 1 500-3 400/mm2,with the average of (2 075.00±555.47)/ mm2, cell morphology was in the normal range, and the percentage of hexagonal cells was(69.98 ± 5.75)%. One week after the surgery, the corneal endothelial cell density changes into 1 300-3 400/mm2, with the average of (2 500.00±500.05/mm2:rate of loss of endothelial cell was 7.92%, the difference of the corneal endothelial cell density before and after surgery was significant (P＜0.01). After the surgery, the change of corneal endothelial cell shape has been observed, and the severity of endothelial cells expanded while polymorphonuclear cells increased,and a hole was observed. Hexagon cell percentage was (53.76±8.26)%. The rate of loss was 15.13 %. The statistical analysis before and after surgery was of significant difference (P＜0.01).Conclusion Phacoemulsification operation on the corneal endothelium damage involves in many factors.In addition to the quality of intraocular lens,it is related with the anterior chamber of viscoelastic,the application of intraoperative perfusion fluid and the surgical instrument sterilization.Surgery on the corneal endothelium injury occurred in the multi-link,and the improved surgical techniques could reduce corneal endothelial cell damage.