文章摘要

白内障合并高度近视患者超声乳化术后视力恢复和角膜内皮细胞损伤程度与核分级的相关性

作者: 1吴小燕, 1麦圣龙, 1邢健强
1 海南爱尔新希望眼科医院综合眼科,海口 570100
通讯: 吴小燕 Email: 286552666@qq.com
DOI: 10.3978/j.issn.2095-6959.2021.06.006

摘要

目的:探讨白内障合并高度近视患者超声乳化术后视力恢复和角膜内皮细胞(corneal endothelial cells,CECs)损伤程度与核分级的相关性。方法:选取自愿接受超声乳化术治疗的113例白内障合并高度近视患者,Emery-Little白内障核硬度分级为II~IV级。依据核分级不同,将纳入患者分成低核分级组(II级)与高核分级组(III~IV级),分别为45例和68例。术后均定期复诊随访8周,观察2组术后角膜水肿发生率和最佳矫正视力(best corrected visual acuity,BCVA)恢复效果,并比较角膜内皮细胞密度(endothelial cell density,ECD)、角膜内皮细胞变异系数(coefficient of variation,CV)和六角形细胞比例(percentage of hexagonal,6A)情况。结果:低核分级组术后角膜水肿发生率(13.33%)低于高核分级组(25.86%),但差异无统计学意义(P>0.05);2组术后1周、8周BCVA均较术前明显提高(P<0.05),低核分级组术后8周的BCVA明显高于高核分级组(P<0.05);2组术后8周角膜ECD和6A均较术前显著减少,角膜CV明显增高(均P<0.05),术后8周低核分级组角膜ECD和6A高于高核分级组,角膜CV低于高核分级组,差异均有统计学意义(均P<0.05)。结论:超声乳化术是治疗白内障合并高度近视的有效术式,患者术后视力恢复效果、CECs损伤程度与核分级密切相关。
关键词: 白内障;高度近视;超声乳化术;核分级;视力恢复;角膜内皮细胞

Correlation between visual acuity recovery, the damage degree of corneal endothelial cells and nuclear grading in cataract patients with high myopia after phacoemulsification

Authors: 1WU Xiaoyan, 1MAI Shenglong, 1XING Jianqiang
1 Department of Comprehensive Ophthalmology, Hainan aierxin hope Eye Hospital, Haikou 570100, China

CorrespondingAuthor: WU Xiaoyan Email: 286552666@qq.com

DOI: 10.3978/j.issn.2095-6959.2021.06.006

Abstract

Objective: To investigate the correlation between aculity recovery, the the damage degree of corneal endothelial cell (CECs) and nuclear grading in cataract patients with high myopia after phacoemulsification. Methods: A total of 113 cataract patients with high myopia who accepted phacoemulsification voluntarily were selected. The Emery-Little cataract nuclear hardness was graded from II to IV. According to different nuclear grades, the patients were divided into a low nuclear grade group (grade II) and a high nuclear grade group (grade III–IV), with 45 cases and 68 cases respectively. All patients were followed up regularly for 8 weeks. The incidence of corneal edema and the effect of best corrected visual acuity (BCVA) in the 2 groups were observed. The corneal endothelial cell density (ECD), coefficient of variation (CV), and percentage of hexagonal (6A) were compared between the 2 groups. Results: The incidence of corneal edema in the low nuclear grading group (13.33%) was lower than that in the high nuclear grading group (25.86%), but there was no significant difference (P>0.05); BCVA of the 2 groups 1 week and 8 weeks after operation was significantly higher than that before operation (P<0.05) and BCVA in low nuclear grade group was significantly higher than that in high nuclear grade group 8 weeks after operation (P<0.05). Eight weeks after operation, the ECD and 6A of cornea in the 2 groups were significantly decreased, and the corneal CV was significantly increased (P<0.05). The corneal ECD and 6A in the low nuclear grading group were higher than those in the high nuclear grading group 8 weeks after operation, and the corneal CV was lower than that in the high nuclear grading group (P<0.05). Conclusion: Phacoemulsification is an effective method for the treatment of cataract with high myopia, and the postoperative visual acuity recovery and damage degree of CECs are closely related to nuclear grading.
Keywords: cataract; high myopia; phacoemulsification; nuclear grading; visual acuity recovery; corneal endothelial cells