[1]申海翠,李佳,张雪彤,等.不同类型白内障囊外摘除术（ECCE）对核硬度≥IV级伴低角膜内皮细胞密度白内障患者的疗效分析[J].眼科新进展,2021,41(3):250-253.[doi:10.13389/j.cnki.rao.2021.0052]
　SHEN Haicui,LI Jia,ZHANG Xuetong,et al.Influence of different types of extra capsular cataract extraction on clinical efficacy and safety of ≥ hard grade 4 cataract patients with low corneal endothelial cell count[J].Recent Advances in Ophthalmology,2021,41(3):250-253.[doi:10.13389/j.cnki.rao.2021.0052]
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不同类型白内障囊外摘除术（ECCE）对核硬度≥IV级伴低角膜内皮细胞密度白内障患者的疗效分析/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年3期
页码:
250-253
栏目:
应用研究
出版日期:
2021-03-05

文章信息/Info

Title:
Influence of different types of extra capsular cataract extraction on clinical efficacy and safety of ≥ hard grade 4 cataract patients with low corneal endothelial cell count
作者:
申海翠; 李佳; 张雪彤; 夏鑫; 王继红
214000　江苏省无锡市，江南大学附属医院眼科
Author(s):
SHEN Haicui; LI Jia; ZHANG Xuetong; XIA Xin; WANG Jihong
Department of Ophthalmology,Affiliated Hospital of Jiangnan University,Wuxi 214000,Jiangsu Province,China
关键词:
双切口; 白内障囊外摘除术; 核硬度; 白内障; 角膜内皮细胞
Keywords:
incision;  extra capsular cataract extraction;  hardness;  cataract;  corneal endothelial cells
分类号:
R776
DOI:
10.13389/j.cnki.rao.2021.0052
文献标志码:
A
摘要:
目的　对比并分析单切口和双切口白内障囊外摘除术（extra capsular cataract extraction，ECCE）对核硬度≥IV级伴低角膜内皮细胞密度白内障患者的疗效。方法　回顾性分析我院2017年1月至2019年12月收治的晶状体核硬度≥IV级且角膜内皮细胞密度<1000 个·mm-2的白内障患者共92例94眼的临床资料，其中46例46眼采用双切口ECCE治疗设为A组，46例48眼采用单切口ECCE治疗设为B组。术后随访6个月，比较两组手术时间及手术前后患者视力、散光度、角膜内皮细胞密度、角膜内皮细胞丢失率、六边形细胞比例及并发症发生情况。结果　两组患者术前基线资料、手术时间及术后视力、术后散光度、术源性散光度等相比，差异均无统计学意义（均为P>0.05）。术后6个月，A组角膜内皮细胞密度为（780.73±110.14）个·mm-2，显著多于B组的（706.15±84.07）个·mm-2，差异有统计学意义（P=0.00）；A组角膜内皮细胞丢失率和六边形细胞比例分别为（4.08±0.52）%和（10.14±6.60）%，均显著少于B组的（10.89±1.40）%和（27.86±9.53）%，差异均有统计学意义（均为P=0.00）。随访期内，A组患者术后角膜水肿发生率为8.70%，显著低于B组患者的37.50%（P<0.05）；A组未见大泡性角膜病变，角膜内皮细胞密度＜600个·mm-2者4眼；B组6眼出现大泡性角膜病变，未见角膜内皮细胞密度＜600个·mm-2者。结论　相较于单切口ECCE，双切口ECCE治疗核硬度≥IV级伴低角膜内皮细胞密度白内障患者可有效保护角膜内皮细胞，降低术后早期角膜水肿发生风险，且两种手术方式整体疗效接近。
Abstract:
Objective　To investigate the influence of single and double incision of extra capsular cataract extraction （ECCE） on clinical efficacy and safety of ≥ hard grade 4 cataract patients with low corneal endothelial cell count. Methods　Clinical data of 92 cataract patients with ≥ hard grade 4 and low corneal endothelial cell （low than 1000 cells·mm-2）were retrospectively chosen in our hospital in the period from January 2017 to December 2019，and divided into 2 groups including A group (46 patients for 46 eyes) with double incision of ECCE and B group (46 patients for 46 eyes) with single incision of ECCE. The baseline clinical data, operation time, and postoperative visual acuity, astigmatism, corneal endothelial cell density and loss rate, proportion of hexagonal cells and complications incidence of 2 groups were compared 6 months after operation.Results　There were no significant difference in the baseline clinical data, the operation time, postoperative visual acuity and astigmatism between 2 groups（all P>0.05）. Six months after operation, the number of corneal endothelial cells in group A ［（780.73±110.14）cells·mm-2］ was significantly higher than that in group B［（706.15±84.07）cells·mm-2］（P=0.000）. The corneal endothelial cell loss rate and proportion of hexagonal cells after operation in group was（4.08±0.52）% and（10.14±6.60）%, respectively, which were significantly lower than those in group B ［（10.89±1.40）% and（27.86±9.53）%, respcetivrly］（P<0.05）. During the follow-up, the incidence of corneal edema in early postoperative period in group A (8.70%) was significantly lower than that in group B (37.50%)（P<0.05）. No bullae keratopathy was observed in group A, and the density of corneal endothelial cells was less than 600 ·mm-2 in 4 eyes. Bulbal keratopathy was observed in 6 eyes of group B, and no patients with corneal endothelial cell density < 600 ·mm-2 was observed.Conclusion　Compared with single incision ECCE, double incision of ECCE in the treatment of ≥ hard grade 4 cataract patients with low corneal endothelial cell count can effectively protect corneal endothelial cells and reduce the risk of early postoperative corneal edema, and the overall efficacy of both is similar.

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备注/Memo

备注/Memo:
N/A
更新日期/Last Update: 2021-03-05