白内障术后乳化硅油进入前房致角膜内皮失代偿1例及文献复习  

Corneal Endothelial Decompensation with Emulsified Silicone Oil in the Anterior Chamber After Phacoemulsification:A Case Report and Literature Review

作　　者：马楠[1] 姜发纲[2] 陈飞[2] MA Nan JIANG Fa-gang CHEN Fei(Department of Ophthalmology, Wuhan Medical Care Center for Women and Children, Wuhan Hubei 430016, China)

机构地区：[1]武汉市妇女儿童医疗保健中心眼科,湖北武汉430016 [2]华中科技大学同济医学院附属协和医院眼科

出　　处：《华南国防医学杂志》2016年第12期777-780,共4页Military Medical Journal of South China

摘　　要：目的阐明乳化硅油进入前房后可能对角膜内皮产生直接毒性和机械阻挡作用,继而诱发角膜内皮失代偿。方法报道1例白内障超声乳化术后乳化硅油进入前房致角膜内皮失代偿的病例,结合既往文献对硅油相关角膜病变的发病机制、发病时间和影像学检查进行探讨。结果 1例27岁男性行白内障超声乳化术后乳化硅油进入前房,致使角膜内皮细胞数量显著下降,丢失率高达42.5%;角膜内皮镜下显示内皮六边形细胞数量下降,平均细胞面积增加,继而发生角膜内皮失代偿。结论对于不易取尽硅油同时合并晶体不全脱位病例需警惕眼内残留乳化硅油进入前房诱发的角膜内皮损害。Objective To investigate that emulsified silicone oil in the anterior chamber may cause direct corneal endothelial toxicity and mechanical barrier,induce corneal endothelial decompensation.Methods One case of corneal endothelial decompensation with emulsified silicone oil in the anterior chamber after phacoemulsification was reported.The pathogenesis,disease time and characteristic image of silicone keratopathy were studied by literature review.Results One case of a 27 year-old young man underwent corneal endothelial cell loss with emulsified silicone oil in the anterior chamber after phacoemulsification,which led to corneal endothelial decompensation.The loss rate of corneal endothelial cell was up to 42.5% and the number of endothelial hexagon cells decreased and the average cell area increased.Conclusion For cases which are difficult to remove silicone oil completely combined with crystal incomplete dislocation,it is vital to guard against the potential corneal endothelial damage with intraocular residual emulsified silicone oil into the anterior chamber.

关 键 词：乳化硅油 角膜内皮 角膜内皮失代偿 

分 类 号：R722.2[医药卫生—儿科] R776.1[医药卫生—临床医学]