[1]宋新志,陈彬川,王永成,等.23G前段玻璃体切割术在浅前房低角膜内皮细胞密度白内障手术中的应用[J].眼科新进展,2016,36(11):1058-1060.[doi:10.13389/j.cnki.rao.2016.0282]
　SONG Xin-Zhi,CHEN Bin-Chuan,WANG Yong-Cheng,et al.23-gague anterior vitrectomy during phacoemulsification for cataract with low corneal endothelial cell density and shallow anterior chamber[J].Recent Advances in Ophthalmology,2016,36(11):1058-1060.[doi:10.13389/j.cnki.rao.2016.0282]
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23G前段玻璃体切割术在浅前房低角膜内皮细胞密度白内障手术中的应用
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
36卷
期数:
2016年11期
页码:
1058-1060
栏目:
应用研究
出版日期:
2016-11-05

文章信息/Info

Title:
23-gague anterior vitrectomy during phacoemulsification for cataract with low corneal endothelial cell density and shallow anterior chamber
作者:
宋新志; 陈彬川; 王永成; 李佳佳; 徐一帆
450014　河南省郑州市，郑州大学第二附属医院眼科
Author(s):
SONG Xin-Zhi; CHEN Bin-Chuan; WANG Yong-Cheng ;  LI Jia-Jia ;  XU Yi-Fan
Department of Ophthalmology,the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014.Henan Province. China
关键词:
23G玻璃体切割系统; 前段玻璃体切割术; 低角膜内皮细胞密度; 浅前房; 白内障; 超声乳化手术
Keywords:
23-gague vitrectomy system;  anterior vitrectomy ;  low corneal endothelial cell density ;  shallow anterior chamber ;  cataract ;  phacoemulsification
分类号:
Ｒ７７９.６６
DOI:
10.13389/j.cnki.rao.2016.0282
文献标志码:
A
摘要:
目的　探讨２３Ｇ前段玻璃体切割联合白内障超声乳化手术治疗浅前房低角膜内皮细胞密度（ｅｎｄｏｔｈｅｌｉａｌｃｅｌｌｄｅｎｓｉｔｙ， ＥＣＤ）白内障的疗效及安全性。方法　根据患者自愿原则，将２０１２年１月至２０１５年１２月在郑州大学第二附属医院接受手术治疗的３０例（３４眼）ＥＣＤ＜１０００ｍｍ－２的浅前房白内障患者分为联合手术组和Ｐｈａｃｏ组。联合手术组１６例（１９眼），行２３Ｇ前段玻璃体切割联合白内障超声乳化术；Ｐｈａｃｏ组１４例（１５眼），行单纯白内障超声乳化术。术后１ｄ、１周及３个月检查两组患者最佳矫正视力、角膜水肿程度，同时记录术前及术后３个月ＥＣＤ，观察角膜水肿消退时间、术中及术后并发症。结果　术后１ｄ，联合手术组最佳矫正视力较术前显著增高，差异有统计学意义（Ｐ＜０．０５）。术后１周及３个月，两组最佳矫正视力均较术前显著增高，差异均有统计学意义（均为Ｐ＜０．０５）。术后１ｄ及１周，联合手术组最佳矫正视力均优于Ｐｈａｃｏ组，差异均有统计学意义（均为Ｐ＜０．０５）。术后１ｄ，联合手术组以１级角膜水肿为主，Ｐｈａｃｏ组以２级角膜水肿为主，两组角膜水肿程度差异有统计学意义（Ｐ＜０．０５）。联合手术组角膜水肿平均消退时间为１．０ｄ，小于Ｐｈａｃｏ组的４．０ｄ，差异有统计学意义（Ｐ＜０．０５）。术后３个月，联合手术组角膜内皮细胞丢失率为（７．８６±０．７６）％，低于Ｐｈａｃｏ组的（１３．３９±０．４７）％，差异有统计学意义（Ｐ＜０．０５）。结论　２３Ｇ前段玻璃体切割联合白内障超声乳化术安全性好，角膜内皮细胞损伤小，术后角膜水肿轻，早期视力恢复快，适用于浅前房低ＥＣＤ白内障患者。
Abstract:
Objective To investigate the outcomes and safety of 23-gague anterior vitrectomy combined with phacoemulsification for cataract with low preoperative corneal endothelial cell density ( ECD) and shallow anterior chamber. Methods Thirty cases (34 eyes) with preoperative ECD of less than 1000 mm -2 and shallow anterior chamber were selected in the Second Affiliated Hospital of Zhengzhou University form January 2012 to December 2015 .in which 16 cases ( 19 eyes) underwent 23-gague anterior vitrectomy combined with phacoemulsification ( combined surgery group) , 14 cases ( 15 eyes) underwent phacoemulsification ( Phaco group) . The best corrected visual acuity and corneal edema were exanuned at postoperative I day ,1 week and 3 months. ECD was recorded preoperative and postoperative 3 months. The regression time of corneal edema,intraoperative and postoperative complications were observed. Results Compared with pre-operation ,the best corrected visual acuity at postoperative I day in the combined surgery group improved significantly ( P < 0. 05 ) . The best corrected visual acuity at postoperative I week and 3 months in the combined surgery group and Phaco group were all better than those before surgery, there were statistical differences ( all P<O. 05 ). The best corrected visual acuity at postoperative I day and I week in the combined surgery group were better than those in the Phaco group ( all P < 0. 05 ) . The corneal edema in the combined surgery group and Phaco group were mainly in grade one and grade two at postoperative I day , respectively , there was a statistical difference (P < 0. 05 ) . The mean regression time of corneal edema in the combined surgery group and Phaco group were l. 0 day and 4. 0 days , respectively , there was statistical difference ( P < 0. 05 ) . The rates of corneal endothelial cell loss at postoperative 3 months in the combined surgery group and Phaco group were ( 7. 86 + 0. 76 ) % and ( 13. 39 + 0. 47 ) % , respectively , there was a statistical difference (P < 0. 05 ) . Conclusion 23-gague anterior vitrectomy combined with phacoemulsification can improve safety , decrease the rate of corneal endothelial cell loss ,reduce postoperative comeal edema,promote the early recovery of visual acuity , and it is appropriate for cataract with low preoperative ECD and shallow anterior chamber.

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更新日期/Last Update: 2016-11-29