实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (7): 710-714.doi: 10.3969/j.issn.1003-9198.2022.07.015

• 临床研究 • 上一篇    下一篇

两种白内障囊外摘除术治疗硬核伴低角膜内皮细胞数白内障病人的疗效观察

许艳, 秦佳音, 赵蕴南, 陈冬梅   

  1. 102300 北京市,北京市门头沟区医院眼科(许艳,赵蕴南,陈冬梅);
    102206 北京市,北京大学国际医院眼科(秦佳音)
  • 收稿日期:2022-03-03 出版日期:2022-07-20 发布日期:2022-07-18
  • 通讯作者: 秦佳音,Email: qinjiayin@pkuih.edu.cn

Effect of two extracapsular cataract extraction methods on patients with hard nucleus cataract and low corneal endothelial cell density

XU Yan, ZHAO Yun-nan, CHEN Dong-mei, QIN Jia-yin   

  1. XU Yan, ZHAO Yun-nan, CHEN Dong-mei. Department of Ophthalmology, Mentougou Hospital, Beijing 102300, China;
    QIN Jia-yin. Department of Ophthalmology, Peking University International Hospital, Beijing 102206, China
  • Received:2022-03-03 Online:2022-07-20 Published:2022-07-18

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摘要： 目的 观察双切口和单切口白内障囊外摘除术治疗老年硬核白内障伴低角膜内皮细胞数病人的疗效及安全性。 方法 收集2017年1月至2020年3月于我院就诊的老年硬核白内障伴低角膜内皮细胞数病人的临床资料,共65例(65眼),根据手术方式分成A组(n=33,行双切口囊外白内障手术治疗)和B组(n=32,行单切口囊外白内障手术治疗)。观察2组病人术中前房维持情况,术后随访6个月,比较2组术后最佳矫正视力(best-corrected visual acuity,BCVA)、角膜内皮细胞密度、中央角膜厚度(central corneal thickness,CCT)和角膜散光度数的差异。 结果 术中注吸皮质时,A组较B组前房更稳定(P＜0.05),2组手术时间差异无统计学意义。2组病人术后1 d BCVA≥0.5眼数比例差异有统计学意义(χ2=4.481,P=0.034),术后1周、1个月、3个月,2组间视力差异均无统计学意义。术后6个月,2组角膜内皮细胞密度及角膜内皮细胞丢失率差异均有统计学意义(P<0.05)。术后1 d,2组CCT均高于术前(P<0.05),但2组术后各观察时点的CCT差异均无统计学意义。2组术后各观察时点的散光度数和术源性散光度数差异均无统计学意义。 结论 与单切口囊外白内障手术相比,双切口囊外白内障手术对硬核白内障伴低角膜内皮细胞数病人的角膜损伤更小,术后视力恢复更快。

关键词: 双切口, 囊外, 白内障手术, 硬核, 角膜内皮细胞

Abstract: Objective To observe the efficacy and safety of extracapsular cataract extraction with double incision or single incision in the elderly patients with hard nucleus cataract and low corneal endothelial cell density. Methods From January 2017 to March 2020, 65 elderly patients (65 eyes) with hard nucleus cataract and low corneal endothelial cell density were enrolled in our hospital. They were divided into two groups according to surgical methods. Group A (33 patients, 33 eyes) underwent double incision extracapsular cataract surgery. Group B(32 patients, 32 eyes) underwent single incision extracapsular cataract surgery. The intraoperative maintenance of anterior chamber in both groups was observed. All the patients were followed up for 6 months, and the best corrected visual acuity (BCVA), the density of corneal endothelial cell, central corneal thickness (CCT) and the degree of corneal astigmatism were compared between the two groups. Results The anterior chamber of group A was more stable than that of group B at irrigating-aspirating (P<0.05). There was no difference in operation time between the two groups. One day after operation, there was significant difference in the proportion of patients with BCVA≥0.5 between the two groups (χ2=4.481, P=0.034), but there were no significant differences in visual acuity between the two groups 1 week, 1 month and 3 months after operation. Six months after operation, there were significant differences in the density of corneal endothelial cell and the rate of corneal endothelial cell loss between the two groups (P<0.05). The level of CCT of both groups 1 day after operation was significantly higher than that before operation (P<0.05), but there were no significant differences in CCT between the two groups at each observation point after operation. There were no significant differences in postoperative astigmatism degree and surgical-induced astigmatism degree between the two groups at each observation point. Conclusions Compared with single incision extracapsular cataract surgery, double incision extracapsular cataract surgery has less corneal injury and faster postoperative visual acuity recovery in the patients with hard nucleus cataract and low corneal endothelial density.

Key words: double incision, extracapsular, cataract surgery, hard nucleus, corneal endothelial cell

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