超声乳化联合IOL植入术对青光眼合并白内障患者角膜内皮细胞的影响

目的:探讨青光眼合并白内障患者采用白内障超声乳化联合IOL植入术治疗对角膜内皮细胞的影响。方法:回顾性分析2016-10/2018-10于我院接受治疗的青光眼合并白内障患者107例113眼,依据治疗方式不同进行分组,对照组52例54眼采用小梁切除术,研究组55例59眼采用白内障超声乳化联合IOL植入术。比较两组患者手术前后视力、前房深度、眼内压、角膜内皮细胞变化和术后并发症发生率。结果:两组患者术前视力情况无差异(P>0.05),术后视力优于术前(P<0.05);术后研究组视力改善情况优于对照组(P<0.05)。两组患者术后前房深度大于术前,眼内压低于术前(P<0.05);术后研究组患者前房深度大于对照组(P<0.05)。术后两组患者眼内压无差异(P>0.05);对照组术后细胞面积变异系数、六角形细胞比例、平均细胞面积、角膜中心厚度高于术前(P<0.05),角膜内皮细胞密度低于术前(P<0.05);手术前后研究组患者上述角膜内皮细胞相关指标无差异(P>0.05),除角膜内皮细胞密度外,术后研究组患者角膜内皮细胞相关指标水平低于对照组(P<0.05)。研究组与对照组术后并发症发生率分别为5.1%和20.4%(P<0.05)。结论:青光眼合并白内障患者采用白内障超声乳化联合IOL植入术可以改善患者视力与眼内高压,保持角膜内皮细胞结构完整性,安全性较好。

Effect of phacoemulsification and intraocular lens implantation on corneal endothelial cells in patients with glaucoma and cataract

AIM: To explore the effect of phacoemulsification and intraocular lens implantation on corneal endothelial cells(CECs)in patients with glaucoma and cataract.

METHODS: The clinical data of 107 patients(113 affected eyes)with glaucoma and cataract who were treated in the hospital during the period from October 2016 to October 2018 were retrospectively analyzed. Patients treated with trabeculectomy or phacoemulsification combined with intraocular lens implantation were included in the control group(n=52, 54 affected eyes)and the study group(n=55, 59 affected eyes). The changes in visual acuity, anterior chamber depth and intraocular pressure before and after surgery, CECs related indexes and incidence of postoperative complications were compared between the two groups.

RESULTS: There was no significant difference in visual acuity between the two groups before surgery(P>0.05). The visual acuity of both groups were significantly improved after surgery(P<0.05), and the improvement in study group was better than that in control group(P<0.05).The anterior chamber depth in both groups increased, while intraocular pressure decreased after surgery(P<0.05). After surgery, anterior chamber depth in study group was significantly larger than that in control group(P<0.05), but there was no significant difference in intraocular pressure between the two groups(P>0.05). The cell area variation coefficient, hexagonal cell ratio, average cell area and corneal center thickness in control group increased significantly, while CECs density decreased significantly after surgery(P<0.05). However, there was no significant difference in CECs related indexes in study group before and after surgery(P>0.05). After surgery, changes levels of CECs related indexes in study group were significantly lower than those in control group(P<0.05). The incidence rates of postoperative complications in study group and control group were 5.1% and 20.4%, respectively(P<0.05).

CONCLUSION: The application of phacoemulsification and intraocular lens implantation in the treatment of glaucoma with cataract can improve the visual acuity and intraocular pressure of patients, maintain structural integrity of CECs, with safety.