摘要
目的评价Duovisc在硬核性白内障超声乳化手术中对角膜内皮细胞的保护作用。方法选择2010年1月到2012年4月就诊于抚顺市眼病医院的病人核硬度Ⅵ级的年龄相关性白内障患者61例，75只眼，随机分为实验组和对照组，术中使用黏弹剂：实验组使用Duovisc，对照组使用爱维。采用相同Infinity超声IP功能、拦截劈裂技术乳化晶状体核，植入相同折叠人工晶状体。比较术后1周、2周、1个月最佳矫正视力，术前、术后1周、1个月、3个月测量角膜厚度、角膜内皮细胞密度、六角形细胞百分数，并计算角膜厚度变化，角膜内皮细胞丢失率，进行统计学分析。结果实验组和对照组LogMAR视力术后1个月分别为（0．11±0．08），（0．12±0．08），两组差异无统计学意义（t=-0．50，P=0．62），术后1周、2周分别为（0．44±0．11）、（0．54±0．23）和（0．20±0．08）、（0．26±0．08），两组差异有统计学意义（t=-2．58，P=0．01；t=-2．91，P〈0．01）。两组患者术前中央角膜厚度、角膜内皮细胞密度、角膜六角形内皮细胞的百分数差异均无统计学意义（P〉0．05），术后各时间点两组角膜厚度差异无统计学意义（P〉0．05），但实验组及对照组角膜增厚程度术后1周、1个月分别为（14．16±6．61）μm、（20．21±6．62）μm；和（8．21±5．22）μm、（12．62±5．13）μm，两组差异有统计学意义（t=-3．88，P〈0．01；t=-3．61，P〈0．01）。术后3个月差异无统计学意义（P=0．05）。实验组及对照组角膜内皮细胞密度术后1周为（2641．58±251．59）个／mm^2，（2489．38±255．31）个／mm^2，两组差异有统计学意义（t=-2．55，P=0．01），术后1个月、3个月差异无统计学意义（P〉0．05）。实验组及对照组术后3个月角膜内皮细胞丢失率（4．16±3．73）％及（8．90±3．00）％，差异有统计学意义（t=-5．90，P〈0．01）。实验组及对照组术后各时间点六角形细胞百分比分别为（49．08±5．38）％及（45．91±4．39）％；（51．18±6．34）％及（47．62±4．59）％；（51．90±6．12）％及（48．62±5．15）％，差异均有统计学意义（t=2．72，P〈0．01；t=2．71，P〈O．01；t=2．44，P=0．02）。结论Duovise在硬核性白内障超声乳化手术中无论在数量及形态上都可以更好地保护角膜内皮细胞。
Objective To evaluate the efficiency of DuoVisc in the protection for corneal endo- thelial cells from damage during phacoemulcification cataract surgery for hard nucteus. Methods As- signed the Grade IV nucleus age-related cataract patients diagnosed in our hospital from Jan 2010 to Apt 2012 randomly to two groups, and used different viscoelastic devices during surgery： DuoVisc and Iviz. All patients were operated on the same surgery technique except the OVD. The best cor- rect visual acuity was measured preoperatively, 1 week, 2 weeks and 1 month postoperatively, corneal endothelial cell density, the central corneal thickness and percentage of hexagonal cells were mea- sured preoperatively and 1 week, 1 month and 3 months postoperatively. The loss rate of endothelial cell density and thickness was calculated. Results LogMAR visual acuity 1 month postoperatively of trial group and control group was （0.11±0.08） and （0.12±0.08）, there was no statistically signifi- cant difference （t =-0.50, P=0.62）, LogMAR visual acuity at 1 week and 2 weeks postoperatively of trial group and control group was （0.44±0.11）, （0.54±0.23） and （0.20±0.08）, （0.26±0.08）, there was statistically significant difference （t =-2.58, P=0.01; t =-2.91, P 〈0.01）. There was no significance dif- ference in corneal thickness, endothelial density, hexagonal cell percentage preoperatively and corneal thickness postoperatively between two groups. But the increase of central corneal thickness of trial group and control group at 1 week, 1 month postoperatively was （14.16±6.61）μm, （20.61±6.62）μm and （8.21±5.22）μm, （12.62.4.5.13）μm, there was statistically significant between two groups （t =-3.88, P 〈0.01; t =-3.61, P 〈0.01）, but no statistically significant 3 months postoperatively （P =0.05）. Endo- thelial density of trial group and control group 1 week postoperatively was （2641.58±251.59）cell/ mm^2, （2489.38±255.31）cell/mm^2, there was statistically significant between two groups （t =2.55, P = 0.01）, but no statistically significant 1 month and 3 months postoperatively. Endothelial cell loss rate of trial group and control group 3 months postoperatively was （4.16±3.73）% and （8.90±3.00）%, there was statistically significant between two groups （t =-5.90, P 〈0.01）. Percentage of hexagonal cell of trial group and control group all points in time postoperatively was （49.08±5.38）%, （45.91±4.39）%; （51.18±6.34）%, （47.62,4,4.59）%; （51.90.4.6.12）%, （48.62±5.15）%, there was statistically significant differ- ent between two groups （t =2.72, P 〈0.01; t =2.71, P 〈0.01; t =2.44, P =0.02）. Conclusions Duo- visc can protect corneal endothelium better than Iviz in phacoemulcification of hard nucleus cataract.
出处
《中国实用眼科杂志》
CSCD
北大核心
2014年第3期356-359,共4页
Chinese Journal of Practical Ophthalmology
