| 双手冷超声乳化术对角膜内皮细胞损伤的临床研究
段智博 刘新平 长沙爱尔眼科医院 湖南爱尔眼科研究所
目的：研究单手与双手两种技术的冷超声乳化术对角膜皮细胞的影响。 方法：老年性白内障患者102例128眼按核硬度分为A、B两组，A组为Ⅲ级核64眼，B组为Ⅳ级核64眼，A、B各组随机分两组，即A1、A2、B1、B2。A1、B1组得双手冷超声乳化术，A2、B2组行单手冷超声乳化术，每组术前、术后1天、3天、7天、1月、3月检查视力，眼压，角膜及前房反应，中央区角膜内皮细计数等。 结果：术后裸眼视力大于或等于0.5：A1组31眼(96.8％)，A2组30眼(93.6％)，B1组28眼(87.5％)， B2组29眼(90.6％)；术后1天，A1、A2组角膜均透明，无后弹力层皱褶，B1组3眼(9.4％)、B2组4眼(12.5％)出现角膜细线状后弹力层皱褶，3天以后全部消退，前房基本未见炎症反应。角膜内皮细胞丢失率在术后随访期内，组内比较无显著性差异(P＞0.05)，术中平均超声能量组内比较无显著性差异(P＞0.05)。 结论：双手冷超声乳化技术作为一种更新的白内障手术方式同单手冷超声乳化技术一样，使用了更小的超声能量，对角膜内皮细胞损伤小， 术后反应轻，恢复快，有广泛的应用前景。 关键词：白内障 双手冷超声乳化术 角膜内皮细胞 损伤
Clinical Study On Corneal Endothelial Cell Lesion During Bimanual Cold Phacoemulsification
Duan Zhibo Liu Xinping
Changsha Aier Eye Hospital,Changsha 410015
Objective To study the effect on corneal endothelial cell during bimanual cold phacoemulsificatiou and single-handed cold phacoemulsification . Methods Cold phacoemulsification was performed on 128 eyes of 102 patients with senile cataracts which were divided into two groups A,B on the nucleus hardness,64 eyes in each group, A for grade Ⅲ,group B for grade Ⅳ. In each group, the patients were again divided into 2 subgroups for bimanual cold phaco and single-handed cold phaco, group A1,B1 for bimanual cold phaco, group A2,B2 for single-handed cold phaco. Preoperatively and in scheduling time postoperatively, the visual acuities, the intraocular pressure, the cornea and anterior chamber reaction and specula microscopy were observed . Results Postoperatively, the uncorrected visual acuities were 0.5 or better in 31 eyes(96.8％) in group A1,30 eyes(93.6％) in group A2 ,28 eyes(87.5％) in group B1,29 eyes(90.6％) in group B2.Postoperatively,the corneas remained transparent in group A1,A2.The slight corneal edema was seen in 3 eyes(9.4％) in group B1 and 4 eyes(12.5％) in group B2.Corneal edema subsided within 3 days. Anterior chamber reaction were not found. There were not significant statistic differences in corneal endothelial cell loss among group A1,A2,B1,B2. Conclusions Bimanual cold phacoemulsification , as single-handed cold phacoemulsification, may reduce the corneal endothelial cell lesion. Key words Cataract, Bimanual cold phacoemulsification, Corneal endothelial cell,
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