关键词: 白内障, 近视, 白内障摘除术

Abstract: Objective To investigate the effects of adrenalin on the corneal endothelium after phacoemulsification cataract surgery in cataract with high myopia and to discuss clinical rational concentration of adrenalin. Methods This retrospective study was comprised of 90 patients(90 eyes) with cataract of high myopia who had undergone phacoemulsification cataract surgery with intraocular lens implantation. 90 patients were divided randomly into three groups:irrigation solution with different concentration adrenalin(0. 1mL,0. 2mL,0. 5mL)and each group 30 eyes. Corneal endothelial cell density and the percentage of hexagonal cells were measured by corneal endothelial cell instrument without touching before surgery and one week after surgery. Results The difference of the preoperative corneal endothelial cell density and hexagonal cell proportion among three groups were not statistically significant(P ﹥ 0. 05). One week after surgery,the cell density in 0. 1mL group,0. 2mL group and 0. 5mL group were respectively(2 495. 24 ± 326. 08)mm - 2 ,(2 457. 45 ± 355. 12)mm - 2 ,(2 425. 38 ± 312. 68)mm - 2 ,the percentage of hexagonal cells in 0. 1mL group,0. 2mL group and 0. 5mL group were respectively(47. 85 ± 12. 01)mm - 2 ,(45. 20 ± 9. 43)mm - 2 ,(44. 35 ± 8. 13)mm - 2 . Both the cell density and hexagonal cell proportion one week after surgery were lower than those before operation. There were significant difference among three groups(P ﹤ 0. 05). Both the cell density and the percentage of hexagonal cell proportion among three groups after surgery were gradually lower with the increase of adrenalin concentration and the comparison among three groups showed that there was no significant difference(P ﹥ 0. 05). Conclusion The tolerance of corneal endothelial cell to surgery injure and adrenalin toxicity is lower in cataract with high myopia. The lower adrenalin concentration should be applied in phacoemulsification cataract surgery to reduce the damage to corneal endothelial cell while maintaining mydriasis state.

Key words: cataract, myopia, cataract ertraction