把握内眼术后角膜水肿行角膜内皮移植术的时机  

Grasp the opportunity of corneal endothelial keratoplasty for corneal edema after internal eye surgery

作　　者：王旭颖 王玮[1] 李贵刚[1] Wang Xuying;Wang Wei;Li Guigang(Department of Ophthalmology,Tongji Hospital Afiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,武汉430030

出　　处：《中华眼科医学杂志（电子版）》2024年第4期193-199,共7页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：国家自然科学基金项目(82070936)。

摘　　要：正常的角膜内皮功能是维持角膜透明的基本条件之一。角膜内皮是单层六角形细胞,在调节角膜水化和透明度方面起着关键作用。各种内眼手术均可能对角膜内皮细胞造成不同程度的损伤,进而引发术后角膜水肿,甚至角膜内皮失代偿,严重影响视力。近年来,随着内眼手术的广泛开展,角膜内皮失代偿的发病率呈逐年上升趋势。鉴别内眼术后角膜水肿是否为不可逆的角膜内皮失代偿,对决定是采用药物保守治疗促进角膜水肿消退,还是及时开展角膜内皮移植术改善视力预后具有重要意义。对术后角膜水肿的患者,早行手术担心过度治疗;晚行手术错失角膜内皮移植良机。因此,内眼术后角膜水肿行角膜内皮移植术的“早”与“晚”,是一个值得广泛关注和讨论的话题。现将就其利弊及依据进行评述。Normal corneal endothelial function is one of the basic conditions to maintain corneal transparency.Corneal endothelium is a monolayer of hexagonal cells,which plays a key role in regulating corneal hydration and transparency.All kinds of internal eye surgery may cause varying degrees of damage to corneal endothelial cells,leading to postoperative corneal edema,even corneal endothelial decompensation,which seriously affects vision.In recent years,with the extensive development of internal eye surgery,the incidence of corneal endothelial decompensation has increased year by year.Identifying whether corneal edema after internal eye surgery is irreversible corneal endothelial decompensation is of great significance to decide whether to use drug conservative treatment to promote the regression of corneal edema or to carry out corneal endothelial keratoplasty in time to improve the prognosis of visual acuity.For the patients with postoperative corneal edema,early surgery is worried about over treatment;late operation missed the opportunity of corneal endothelial keratoplasty.Therefore,the“early”and“late”of corneal endothelial keratoplasty for corneal edema after intermal eye surgery is a topic worthy of wide attention and discussion.The pros and cons and the basis were reviewed.

关 键 词：角膜水肿 角膜内皮失代偿 角膜内皮移植 角膜 

分 类 号：R779.6[医药卫生—眼科]