白内障患者术后角膜内皮细胞计数减少的多因素分析

目的：探讨白内障患者超声乳化术后影响角膜内皮细胞数目减少的相关因素。

方法：选取我院眼科采用超声乳化术治疗的98例120眼进行回顾性分析，收集时间2014-07/2016-07； 根据患者术后2mo复查角膜中央内皮细胞密度与术前进行比较分为严重丢失组52例67眼(角膜中央内皮细胞丢失率≥12.3%)，一般丢失组46例53眼(角膜中央内皮细胞丢失率<12.3%)，对比两组患者的一般资料、手术相关指标，采用非条件Logistic回归分析法探讨影响白内障患者术后角膜内皮细胞丢失的影响因素。

结果：严重丢失组和一般丢失组的性别、合并高血压、合并糖尿病、合并高血脂、浅前房、角膜直径增大、注吸时间比较，差异均无统计学意义(P>0.05)； 两组比较的Emery晶状体核硬度分级、超声能量、超声乳化时间、年龄构成差异具有统计学意义(P<0.05)； 采用非条件Logistic分析法，结果显示Emery晶状体核硬度分级增高、超声能量增加、超声乳化时间较长、年龄增大是超声乳化术治疗后角膜内皮细胞数目严重减少的独立危险因素(P<0.05)。

结论：白内障患者超声乳化术后影响角膜内皮细胞数目减少的主要因素为Emery晶状体核硬度分级增高、超声能量增加、超声乳化时间较长、年龄增大。

Multivariate analysis of corneal endothelial cell count reduction after cataract surgery

AIM:To investigate the factors related to the decrease of corneal endothelial cell number after phacoemulsification in cataract patients.

METHODS: We selected 98 patients(120 eyes)in Ophthalmic Center from July 2014 to July 2016 underwent phacoemulsification and they were retrospectively analyzed. According to the central corneal endothelial cell density before and 2mo after the operation, they were divided into serious loss group of 52 cases(67 eyes, density of central corneal endothelial cells loss rate no less than 12.3%), the general loss group of 46 cases(53 eyes, the density of central corneal endothelial cell loss rate <12.3%). Relevant indicators of general information, operation of the two groups were compared, the influence factors of non conditional Logistic regression analysis method was used to investigate the effect for corneal endothelial cell loss in cataract patients.

RESULTS: Serious loss group and the general group on gender, rate with hypertension, rate with diabetes, rate with high blood lipids, with shallow anterior chamber, corneal diameter and suction time comparison, had no statistically significant differences(P>0.05). Nuclear hardness classification of Emery lens, ultrasonic power, ultrasonic emulsification time, age between groups were significantly different(P<0.05). By using Logistic analysis method, the results showed that increased Emery lens nucleus grading, ultrasonic energy, phacoemulsification time, age were independent risk factors for corneal endothelial cells after phacoemulsification(P<0.05).

CONCLUSION: The main factors that influence the decrease of corneal endothelial cell number after phacoemulsification are Emery lens, higher grade of nucleus of lens, increase of ultrasonic energy, longer time of phacoemulsification and increased age.