小梁切除术后白内障冷超乳摘除对角膜切口和内皮细胞的影响

目的探讨小梁切除术后白内障冷超乳摘除对角膜切口和内皮细胞的影响。方法对39例（40眼）连续小梁切除术后Ⅲ级核白内障手术患者随机分组，试验组（20例20艰）采用白内障冷超乳摘除，对照组（20例19眼）采用普通超声乳化技术。比较两组术后视力、角膜切口水肿、手术源性散光和角膜内皮数量变化。结果术后第3个月，两组术后矫正视力≥4．6：试验组10眼，对照组9眼，两者比较差异无显著性（P〉0．05）；手术源性散光：试验组平均为（0．67±0．59）D，对照组平均为f0．70±0．45）D，两者比较差异无显著性（P〉0．05）；角膜切口水肿：试验组6眼，对照组15眼，两者比较差异有显著性（P〈0．05）；角膜内皮数量减少：试验组手术前后平均减少为（185±67）个／mm^2，对照组平均减少为（294±98）个／mm^2，两者比较差异有显著性（P〈0．05）。结论透明角膜切口冷超乳摘除小梁切除术后白内障对角膜切口和内皮损伤较小，术后角膜并发症较少．提高了手术安全性。

Effects of cold phacoemulsification after trabeculectomy on corneal incision and endoepithelium

Objective To investigate the effects of cold phacoemulsification after trabeculectomy on corneal incision and endoepithelium. Methods All cases were divided randomly into two groups：test group and control group. Clear corneal tunnel cold phacoemulsification and intraocular lens （IOL） implantation were performed on 20 eyes of 20 cases in the test group and conventional temporal corneal tunnel phacoemulsification and IOL implantation on 20 eyes of 19 cases in the control group. The postoperative corrected visual acuity, the edema of the corneal incision, the surgical induced corneal astigmatism and the number of corneal endothelial cells were compared. Results The corrected visual acuity ≥0.4 in the test group were 10 eyes and in the control group were 9 eyes after three months. The surgical induced corneal astigmatism in the test group was （0.67±0.59）D and in the control group was （0.70±0.45）D. There were no statistically significant difference between the corrected visual acuity and the surgical induced corneal astigmatism （P〉0.05）. The edema of corneal incision in the test group were 6 eyes and in the control group were 15 eyes. The endothelial cell loss in the test group were （185±67）/mm^2 and in the control group were （294±98）/mm^2. The edema of corneal incision and the endothelial cell loss in the control group were higher than that in the test group, which had statistically significant difference （P〈0.05）. Conclusion Clear corneal tunnel cold phacoemulsification and IOL implantation lower the energy of phacoemulsification and decrease the risk of corneal incision burn and endothelial cell loss, which improve the safty of the surgery.