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目的观察不同材料和设计的人工晶状体(IOL)植入患眼后引起的前房炎症反应有无差异。设计病例系列研究。研究对象67例(67眼)行白内障超声乳化吸除术患者。方法将患者分成A(24例)、B(21例)、C(22例)三组,A组植入第三代硅凝胶IOL,B组植入亲水丙烯酸酯IOL,C组植入肝素表面修饰的亲水丙烯酸酯IOL。手术前及术后第1、7、28天用激光房水闪光细胞仪测量前房房水的闪光(flare)和细胞(cell)计数值,以判断前房炎症反应程度。主要指标激光房水闪光细胞仪测量的flare值、cell值。结果A、B、C三组术后第1天的flare值分别为(17.5±7.9)、(17.0±6.7)、(11.6±5.8)光子数/毫秒(pc/ms),cell值分别为(13.1±5.9)、(13.7±5.8)、(9.4±3.7)个/立方毫米(num/mm3);A、B、C三组术后第7天的flare值分别为(9.5±5.6)、(8.8±5.0)、(5.6±3.0)pc/ms,cell值分别为(6.5±4.6)、(5.6±2.9)、(3.6±2.9)num/mm3。术后第1、7天C组的flare和cell值明显小于A组和B组,差异有统计学意义(P<0.05),而A、B两组间差异无统计学意义。术前及术后第28天,三组之间flare和cell值均无统计学差异。结论植入肝素表面处理的人工晶状体者白内障术后早期炎症反应较其它两种轻,激光房水闪光细胞仪是定量测量白内障术后炎症反应安全有效的工具。
Objective To observe whether there is any difference in inflammatory reaction in the anterior chamber after implantation of IOL with different materials and designs. Design case series research. 67 patients (67 eyes) underwent cataract phacoemulsification. Methods The patients were divided into three groups: A (24 cases), B (21 cases) and C (22 cases). The third generation silicone gel IOL was implanted in group A, the hydrophilic acrylic IOL was implanted in group B, Heparin surface-modified hydrophilic acrylate IOL. The anterior chamber aqueous flare and cell count values were measured before and after surgery on days 1, 7 and 28 with laser flash light cytometry to determine the extent of anterior chamber inflammation. The main indicators of laser room water flash cytometry Flare value, cell value. Results The flare values of the first day after operation in groups A, B and C were (17.5 ± 7.9), (17.0 ± 6.7) and (11.6 ± 5.8) photons / ms and the cell values were ( (9.5 ± 5.6), (13 ± 5.9), (13.7 ± 5.8) and (9.4 ± 3.7) / mm3, respectively. The flare values of the 7th day after the operation in group A, B and C were (9.5 ± 5.6) 8.8 ± 5.0) and (5.6 ± 3.0) pc / ms respectively. The cell values were (6.5 ± 4.6), (5.6 ± 2.9) and (3.6 ± 2.9) num / mm3, respectively. The flare and cell counts of C group were significantly lower than those of A group and B group on the 1st and 7th day after operation (P <0.05). There was no significant difference between A and B groups. There was no significant difference in flare and cell between the three groups before and 28 days after operation. Conclusions The intraocular lens implanted with heparin surface is lighter than the other two in early postoperative cataract surgery. Laser flash light cytometry is a safe and effective tool for the quantitative measurement of inflammatory reaction after cataract surgery.