飞秒激光辅助的白内障手术与传统超声乳化手术对角膜内皮细胞形态及功能的影响比较

目的：探究飞秒激光辅助的白内障手术与传统超声乳化手术对角膜内皮细胞形态及功能的影响。

方法：本探究对象为2016-01/2017-01于我院手术治疗的白内障患者80例88眼，所有患者均进行超声乳化手术联合人工晶状体植入。通过对治疗回顾性分析进行比较研究，将40例43眼采用飞秒激光辅助的白内障手术治疗的患者设为观察组，只行传统超声乳化手术治疗的40例45眼患者设为对照组，比较两组患者术后裸眼视力>0.5比例，并记录各患者术中前囊切开直径、囊膜大小、术中累积释放能量(CDE)，记录术前、术后角膜内皮细胞密度以及角膜内皮细胞变异系数，并比较两组患者手术前后六角形细胞比例。

结果：观察组术后1d裸眼视力>0.5眼与对照组差异无统计学意义，术后6mo为74%，显著高于对照组(53%)，差异有统计学意义(P<0.05)； 观察组患者前囊切开直径、囊膜大小、Ⅱ级核CDE、Ⅲ级核CDE与对照组差异有统计学意义(P<0.05)； 两组患者术前、术后角膜内皮细胞密度以及角膜内皮细胞变异系数、六角形细胞比例差异显著，且术后6mo观察组与对照组差异有统计学意义(P<0.05)。

结论：飞秒激光辅助白内障手术能降低超声能量对角膜的影响，能显著降低对角膜内皮细胞形态及功能的损害。

Effects of femtosecond laser assisted cataract surgery and conventional phacoemulsification on corneal endothelial cell morphology and function

AIM: To investigate the effect of femtosecond laser assisted cataract surgery and conventional phacoemulsification surgery on corneal endothelial cell morphology and function.

METHODS: This study included 80 cases of cataract patients(88 sicked eyes)treated in our hospital from January 2016 to January 2017. All patients underwent phacoemulsification combining with intraocular lens implantation for treatment. Based on the review of treatment, 40 cases(43 sicked eyes)receiving femtosecond laser assisted cataract surgery were included into the observation group, 40 cases(45 sicked eyes)receiving conventional phacoemulsification only were divided into the control group. The proportion of patients whose postoperative uncorrected visual acuity >0.5 of the two groups were compared, and sac diameter, capsule size, intraoperative cumulative energy release(CDE)were recorded, the corneal endothelial cell density and variation were recorded before and after operation, the preoperative and postoperative ratio of hexagonal cells were compared between the two groups subsequently.

RESULTS: At 1d postoperatively, uncorrected visual acuity >0.5 of the observation group was no significant difference with that of the control group; the ratio was 74% at 6mo after surgery, which was significantly higher than that of the control group(53%), there was statistical significance(P<0.05). The diameter of the anterior capsulotomy, the size of the capsule, the grade II nuclear CDE, and the grade III nuclear CDE of the observation group were sharply different from those of the control group, there was statistical significance(P<0.05). The differences of corneal endothelial cell density and variation, proportion of hexagonal cells before and after surgery of the two groups were significant, and the difference after 6mo between the two groups was huge, there was statistical meaning(P<0.05).

CONCLUSION: Femtosecond laser assisted cataract surgery can reduce the effect of ultrasound energy on cornea, and can sharply decrease the damage to corneal endothelial cell morphology and function.