手术源性角膜内皮失代偿原因分析  

Etiology of surgically induced corneal endothelial dystrophy

作　　者：洪颖[1] 范爽[1] 卢迪[2] 许永根[1] 洪晶[1] 

机构地区：[1]北京大学第三医院,北京100191 [2]延边大学附属医院,延吉市133000

出　　处：《中国实用眼科杂志》2012年第7期816-819,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的分析手术源性角膜内皮失代偿的原因。方法收集自2007年1月至2011年4月因内眼手术后角膜内皮失代偿而行角膜移植术的患者，记录患者的原发病，合并的眼部疾病，手术方式，植入的人工晶状体的类型，手术次数等。所有患者行详细的眼部检查，包括裂隙灯显微镜、检眼镜、共聚焦显微镜、眼前节照相等。结果共有98例患者纳入研究。其中男性53例，女性45例。年龄19-85岁，平均年龄65岁。研究中造成手术源性角膜内皮失代偿的手术术式有：白内障类手术共67例占69％（包括单纯白内障摘除及后房型人工晶状体植入术的54例；青光眼白内障联合手术3例，合并Fuehs角膜内皮营养不良患者10例）；前房内人工晶状体14例占14％（前房型人工晶状体13例，虹膜夹型人工晶状体脱位至前房1例）；玻璃体视网膜手术14例占14％（接受单次手术4例，接受多次手术10例）；抗青光眼手术3例占3％。结论显示在手术源性角膜内皮失代偿中，白内障类手术占第一位；前房相关人工晶状体及玻璃体视网膜手术占第二位；抗青光眼手术后发病最低。Objective To analyze the etiology of surgically induced corneal endothelial dystro- phy. Methods All patients came to our hospital for corneal transplantation surgery from January 2007 to April 2011 were enrolled. The original diseases, combined ocular disease, surgery types, IOL types and times of surgery were recorded. Detailed examinations were preceded on all patients including slit lamp, ophthalmoscope and confocal microscope. Results There were 98 patients in this study, including 53 males and 45 females. Age ranged from 19 to 85 years old with an aver- age age 65 years old. Sixty-seven cases were post cataract surgery （including 54 cases after cataract and IOL implantation, 3 cases after combined cataract and anti-glaucoma surgery, 10 cases with Fuch endothelial dystrophy before surgery）. Fourteen cases were induced by anterior chamber related IOL （including 13 cases with AC-IOL, 1 case with dislocated iris-fixed IOL）. Fourteen cases were post vitreoretinal surgery （including 4 cases received once and 10 cases received multiple surgery）. The rest 3 cases were post antiglaucoma surgery. Conclusions Our study suggests the proportion of surgically induced corneal endothelial dystrophy is as follows： cataract surgery 69%; anterior cham- ber related IOL 14%, vitreoretinal surgery 14% and anti-glaucoma surgery 3%.

关 键 词：手术源性 角膜内皮失代偿 病因学 

分 类 号：R772.2[医药卫生—眼科]