摘要
目的探讨小切口白内障摘出术后影响角膜内皮细胞损伤危险因素。方法 277例患者(464只眼)行小切口白内障摘出术,记录患者术后两个月的恢复情况和影响患者术后角膜细胞丢失率的指标,并进行单因素分析和多元logistic回归分析小切口白内障摘出术后角膜内皮细胞损伤危险因素。结果术后两个月,患者裸眼视力(UCVA)、最佳矫正视力(BCVA)、平均细胞面积(AVG)、细胞变异度(CV)、角膜内皮细胞密度(CECs)及六边形比率等指标均明显优于术前,差异均有统计学意义(t分别=24.67、25.33、18.50、14.03、102.01、17.18,P均<0.05)。单因素分析显示,不同丢失率间的年龄、切口位置、灌注压力、原角膜损伤发生率、后弹力层撕脱发生率、核硬度有明显差异(χ2分别=4.90、31.04、5.00、13.63、12.87、4.30,P均<0.05)。多元logistic回归分析显示,切口靠前、原角膜损伤、后弹力层撕脱、核硬度高为角膜内皮细胞损伤危险因素(OR分别=1.74、1.98、1.46、2.22,P均<0.05)。结论避免切口靠前、器械入眼角度错误及术中高灌注压是降低小切口白内障摘出术角膜内皮细胞损伤的有效方法。
Objective To investigate the risk factors of corneal endothelial cell injury after small incision cataract extraction. Methods Totally 277 patients（464 eyes）who underwent small incision cataract surgery were included. The recovery effects and the parameters that influencing corneal cell loss rate were recorded. Univariate analysis and multiple regression logistic analysis were used to evaluate the risk factors of corneal endothelial cell injury after small incision cataract extraction. Results Two months after surgery,the uncorrected visual acuity（UCVA）,best corrected visual acuity（BCVA）,mean cell area（AVG）,cell variability（CV）,corneal endothelial cell density（CECs）and hexagonal ratio were significantly improved（t=24.67,25.33,18.50,14.03,102.01,17.18,P〈0.05）.The univariate analysis showed that the different incidences of corneal endothelial cell injury had statistical significance in age,position of incision,perfusion pressure,incidence of corneal injury,incidence of descemet avulsion,nuclear hardness（χ2=4.90,31.04,5.00,13.63,12.87,4.30,P〈0.05）. Logistic analysis showed that front position of incision,corneal injury,descemet avulsion and nuclear hardness were risk factors for corneal endothelial cell injury（OR=1.74,1.98,1.46,2.22,P〈0.05）. Conclusion An effective way to reduce corneal endothelial cells injury in small incision cataract surgery is avoiding the front position of incision,angle of instrument insertion and high perfusion pressure.
出处
《全科医学临床与教育》
2018年第1期38-41,共4页
Clinical Education of General Practice
关键词
白内障
小切口摘除术
角膜内皮细胞损伤
cataract
small incision extraction
corneal endothelial cell injury
