狼疮性肾炎患者白内障超声乳化术后角膜内皮细胞的观察

目的：评价白内障超声乳化术对合并有狼疮性肾炎(lupus nephritis，LN)的白内障患者角膜内皮细胞的影响。

方法：选取40例40眼 LN合并白内障患者(LN组)，以及50例50眼单纯性白内障患者(对照组)，行白内障超声乳化联合人工晶状体植入术，术前以及术后1mo通过角膜内皮细胞显微镜检测内皮细胞密度(cell density，CED)、平均内皮细胞面积(average area of endothelial cell，AVE)、变异系数(coefficient of variation，CV)。所得数据通过SPSS 13.0进行统计学分析。

结果：与术前相比，术后1mo，LN组和对照组的角膜内皮形态功能差异有统计学意义。两组的CED均减少，AVE和CV均增加(均P<0.05)。与对照组相比，术后LN组的CED减少的更加显著，AVE和CV增加的幅度更大(均P<0.05)。

结论：LN白内障患者的角膜内皮细胞对超声乳化白内障吸除术产生的损伤更加敏感，所以手术操作中应当格外谨慎。

Effect of phacoemulsification on corneal endothelium of cataract with lupus nephritis

AIM:To evaluate the influence of phacoemulsification on corneal endothelium of senile cataract with lupus nephritis(LN).

METHODS:This clinical trial involved 40 cataract patients with lupus nephritis(40 eyes), and 50 cases(50 eyes)without lupus nephritis. All of them underwent phacoemulsification+IOL implantation. The parameters of corneal endothelial cell including central corneal endothelium cell density(CED),average area of endothelial cell(AVE)and coefficient of variation(CV)were recorded by corneal endothelial microscope pre-operation and at one month after operation. The data were analyzed by SPSS 13.0 statistical software.

RESULTS:Both LN group and control group, the morphology of coneal endothelial was statistical significant differences between pre-operation and 1mo postoperation. The CED was lower, AVE and CV were higher(P<0.05, respectively).A significant decrease in CED was seen in the LN group than did in the control group(P<0.05).Compared to control group,the post-operative AVE and CV in LN group was significantly increased(P<0.05).

CONCLUSION:The corneal endothelial cell in lupus nephritis patients is more fragile. Safe and reliable operation should be selected for these patients.