不同玻璃体视网膜手术方式对角膜内皮细胞密度影响  

EFFECTS OF DIFFERENT VITREORETINAL SURGERIES ON CORNEAL ENDOTHELIAL CELL DENSITY

作　　者：王桂法[1] 周占宇[1] 杨文毅[1] 张爱华[1] 

机构地区：[1]青岛大学医学院附属医院眼科,山东青岛266003

出　　处：《齐鲁医学杂志》2012年第3期255-257,共3页Medical Journal of Qilu

摘　　要：目的探讨不同玻璃体视网膜手术方式对角膜内皮细胞密度的影响。方法对68例(68眼)伴有晶状体浑浊的玻璃体视网膜疾病病人经睫状体扁平部行玻璃体切除联合晶状体切除术,术中完整保留晶状体前囊膜,并根据玻璃体腔填充物不同分为BSS组、C3F8组和硅油组,分别于术前、术后2周、术后1个月、术后3个月进行术眼角膜内皮细胞计数。结果 BSS组不同时间角膜内皮细胞密度无明显差异(H=5.62,P>0.05),但存在减小趋势;C3F8组术后2周与术前相比角膜内皮细胞明显减少(H=12.14,Z=-3.25,P<0.05),手术2周后内皮稳定,术后1、3个月与术后2周相比无明显差异(Z=0.921、-1.095,P>0.05);硅油组术后2周与术前相比,术后1、3个月与术后2周相比角膜内皮细胞密度均明显下降(H=39.98,Z=-4.01～-2.50,P<0.05)。结论在完整保留晶状体前囊膜的玻璃体联合晶状体切除手术中,BSS填充术后角膜内皮细胞密度无明显下降,C3F8和硅油填充术后角膜内皮细胞密度明显下降,根据病人病情选择恰当的手术方式对保护角膜内皮有积极的意义。Objective To assess the effect of different types of vitreoretinaI surgery on corneal endothelial cell density （CECD）. Methods Sixty-eight patients （68 eyes） with vitreoretinopathy accompanied by lens opacity underwent vitrectomy combined lensectomy, of which, the anterior capsules were preserved. The patients were divided into three groups, according to different fillers used, as BSS group, C3Fs group and silicon-oil group. Corneal endothelial cell count was done preoperatively and two weeks, one and three months after surgery. Results There was no significant differences of CECD in BSS group among dif- ferent times of point （H^5.62,P^0.05）, but a tendency of growing down was indicated. In CaFs group, the CECD dramatically decreased two weeks after surgery than before （H=12.14,Z=-3.25,P〈0.05）. The CECD became stable two weeks after sur- gery. No significant differences of CECD were found one and three months after surgery versus that two weeks postoperatively （Z=0. 921 --1. 095 ;P〉0.05）. In silicon-oil group, the CECD decreased obviously two weeks after surgery compared with before surgery, as well as two and three months after surgery versus two weeks after surgery （H= 39.98, Z=- 4.01-- --2.50,P〈 0.05）. Conclusion In the surgery of vitrectomy comhined [ensectomy, with preserving anterior lens capsule, the CECD was not decreased after filling with BSS, but the CECD declined dramatically after filling with C3Fa or silicon oil. It is essential, based on individual patient, to choose a correct procedure to protect patient＇s corneal endothelia.

关 键 词：内皮 角膜 晶体 玻璃体切除术 

分 类 号：R776.4[医药卫生—眼科]