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目的用角膜内皮细胞显微镜对糖尿病性白内障患者术前及术后进行角膜内皮细胞摄相观察,以探讨其角膜内皮细胞的变异情况。方法选择糖尿病性白内障患者28例(30只眼),用角膜内皮显微镜对其术前及术后3～6月角膜内皮的细胞密度、平均细胞面积、细胞大小变异系数及细胞形态进行检查。结果术前和术后3～6月的角膜内皮细胞密度分别为(2334.61±322.42)个/mm2和(2045.23±376.82)个/mm2,细胞丧失率为12.11%;平均细胞面积分别为(340.29±127.22)um2和(390.12±213.44)um2;变异系数分别为42.55%和53.21%;六角形细胞比率分别为(54.32±12.53)%和(45.51±13.93)%。上述结果,统计学上差异均有显著性(P<0.05)。结论糖尿病性白内障患者术后的角膜内皮细胞密度减少,细胞丧失率增大,平均细胞面积及细胞大小变异系数增大,标准的六角形细胞比率变小,说明白内障手术对糖尿病患者角膜内皮细胞具有一定的损伤性;但患者术后角膜透明,并获得良好视力,因此,手术仍是糖尿病性白内障失明患者复明的重要手段。
Objective To observe the changes of corneal endothelial cells by corneal endothelial cell microscopy before and after operation in patients with diabetic cataract. Methods 28 patients (30 eyes) with diabetic cataract were selected. The corneal endothelial cell density, average cell area, coefficient of variation of cell size and morphology of corneal endothelium were detected by corneal endothelial microscopy before and 3 to 6 months after surgery. Results The corneal endothelial cell densities were (2334.61 ± 322.42) / mm2 and (2045.23 ± 376.82) / mm2 respectively before operation and 3 ~ 6 months after operation, the cell loss rate was 12.11%, and the average cell area was (340.29 ± 127.22) um2 and (390.12 ± 213.44) um2 respectively; the coefficient of variation was 42.55% and 53.21% respectively; the ratio of hexagonal cells was (54.32 ± 12.53)% and (45.51 ± 13.93)%, respectively. The above results were statistically significant differences (P <0.05). Conclusions In patients with diabetic cataract, the corneal endothelial cell density is decreased, the cell loss rate is increased, the average cell area and cell size coefficient of variation are increased, and the standard hexagonal cell ratio is smaller, indicating that cataract surgery has the following effects on corneal endothelial cells of diabetic patients: Certain damage; but patients with corneal transparency and good visual acuity, therefore, surgery is still an important means of patients with blindness of diabetic cataract.