白内障术后一年角膜内皮细胞持续损失  

Continued cell loss in corneal endothelium after cataract surgery

作　　者：陈冬梅[1] 吴静安[1] 

机构地区：[1]北京医科大学第一医院眼科

出　　处：《北京医科大学学报》1999年第4期337-340,共4页Journal of Peking University(Health Sciences)

摘　　要：目的：观察无并发症白内障囊外摘除加后房人工晶体植入术（ＥＣＣＥ＋ＩＯＬ）与角膜内皮损伤的关系。方法：应用接触式角膜内皮显微镜观察了３０例（３０眼）老年性白内障患者，行ＥＣＣＥ＋ＩＯＬ术前及术后１月、２月、３月、１年时中央及上方角膜内皮细胞密度、细胞形状的变化。结果：术前中央角膜内皮细胞密度平均为（２８２８±４００）ｍｍ－２，六边形细胞百分率（Ｈｅｘａ％）为（６２±６）％。术后角膜内皮细胞密度低于术前，中上角膜间差异有显著性。术后３个月时内皮细胞损失，中央为１２．６％，上方为３５．５％；术后１２个月中央及上方角膜内皮损失分别上升为１６．２％和４３．０％。术后一年内有持续的内皮细胞损失。术后上方、中央角膜Ｈｅｘａ％先明显下降，后逐渐回升，在术后１２个月接近术前水平。结论：白内障术后角膜内皮细胞可能存在持续损失，故术前检查密度较低的内皮，不仅要估计是否经得住手术创伤，还要考虑是否能承受术后长期慢性内皮细胞损失。Objective: To detect the corneal endothelium damage after extracapsular cataract extraction with posterior chamber lens implantation(ECCE+IOL). Methods: Changes in corneal endothelial cell density and cell shape of 30 senile cataract cases(30 eyes) were observed 1,2,3 and 12 months after ECCE+IOL. Results: Before surgery, the mean corneal endothelial cell density was (2 828 ±400) mm -2 , and the percentage of hexagonal cells(Hexa%) was (62±6) % in central cornea. After ECCE+IOL, the corneal endothelial cell density and Hexa% decreased remarkably, especially in the superior cornea. There was a significant difference between central and superior cornea. 1,3 and 12 months after the surgery, the endothelial cell losses of central cornea were 11.2%, 12.6% and 16.2 %, respectively, which suggested progressive cell loss during the first year. The Hexa% of superior and central cornea endothelium increased gradually after the immediate decrease, but didn't return to preoperative level within 1 year. Conclusion: There may be continued cell loss in corneal endothelium after cataract surgery.

关 键 词：白内障摘除术 人工晶体植入 角膜 内皮细胞 

分 类 号：R779.66[医药卫生—眼科]