白内障摘出术后角膜失代偿的病理形态学研究  

Histopathologic observation of corneal decompensation after cataract extraction

作　　者：石海红[1] 李永平[1] 张平[1] 钟秀风[1] 林健贤[1] 张文忻[1] 郑健粱[1] 

机构地区：[1]中山大学眼科中心

出　　处：《眼外伤职业眼病杂志》2007年第9期665-669,共5页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

基　　金：广东省科技计划基金资助项目(2003A3020302)

摘　　要：目的探讨白内障摘出术后角膜失代偿的组织病理学改变。方法收集91例(91眼)白内障术后角膜失代偿行穿透性角膜移植的受体角膜标本,常规包埋切片,全部做HE染色,部分做PAS染色和胶性铁染色,光学显微镜观察。结果角膜上皮细胞水肿,细胞间隙增宽,上皮下大泡形成,表面不规则,部分病例角膜上皮内生。前弹力层肿胀,局部破坏消失。角膜基质层增厚水肿,基质纤维间隙增宽,部分病例有炎症细胞浸润,伴新生血管和纤维增生。后弹力层略增厚,板层样染色不均,部分形成双层后弹力层样外观。内皮细胞扩大、退变,稀疏甚至消失。部分病例角膜后膜形成。结论角膜内皮细胞大量减少、角膜上皮内生、角膜后膜形成是导致白内障术后角膜失代偿病理改变的原因。Objective To investigate the histopathologic changes of the corneal decompensation after cataract extraction and intraocular lens implantation. Methods Collect 91 corneas of bullous keratopathy after penetrating keratoplasty due to cataract sur- gery. After routine embedment, section and stain have been done, light microscope were observed. Results The pathologic changes of epithelium was remarkably with it＇s epithelium edema, degener- ation, interstitial fluid accumulation, bulla formation and epithelium ingrownth. The surface of the epithelium is irregular because abnormal epithelial healing. Bowman＇ s layer was edema and was degeneration in some areas. Stromal is increased in thickness as a result of accumulation of the fluid within and between the lamellae. Stromal edema is accompanied by inflammation, neovascular andproliferation in some cases. Descemet＇ s membrane is irregular, diffuse thickening. Endothelial cells flatted, enlarged and disappeared in some areas and retrocorneal membrane was formed in some cases. Conclusions The decrement of corneal endothelial in great number,epithelium downgrowth and retrocorneal membrane formation resulted in the pathologic changes of corneal decompensation after catract extraction.

关 键 词：白内障 角膜失代偿 组织病理学 

分 类 号：R779.66[医药卫生—眼科] R772.2[医药卫生—临床医学]