硅油填充术后的角膜内皮改变

Effect of silicone oil injection on corneal endothelium

目的评价硅油对有晶状体及无晶状体眼角膜内皮的影响。方法对45例(45眼)视网膜脱离患者行玻璃体切割联合硅油填充术,其中有晶状体组(22眼)及无晶状体组(23眼),比较其术前,术后1、3、6、9个月的改变。了解前房硅油对角膜内皮的影响。结果两组患者手术前后角膜内皮细胞的密度及角膜厚度的改变均无统计学差异,但两组同期角膜内皮细胞密度比较在术后1个月、6个月呈现显著差异(P=0.002,P=0.034)。硅油接触角膜内皮时,呈现“亮度颠倒”现象。末次随访时(术后9个月)的内皮细胞密度与无前房硅油组相比有极显著差异(P=0.000)。结论无论晶状体是否存在,玻璃体腔内的硅油对角膜内皮无明显的损害。而当硅油进入前房则将对角膜内皮造成严重的损害。

Objective To evaluate the changes of corneal endothelium in aphakic and phakic eyes after silicone oil tamponade. Methods Forty-five cases（45 eyes） received pars plana vitreetomy with silicone oil tamponade,including phakie eyes （22 eyes） arid aphakic eyes （23 eyes ） , were followed-up. The changes of corneal endothelium were observed at the end of the 1 st,3rd,6th and 9th months. Cnrneal endothelium cell counting and corneal thickness were determined with microscopy of the corneal endothelium and ultrasonic ecbogram, respectively. Results There were no statistical differences in corneal endothelium cell density and corneal thickness prior to and after the injection of silicone oil. The corneal endothelium density in aphakic eyes was significantly less than that in phakic eyes at the 1st and 6 th month after surgery （ P = 0. 002,P = 0. 034） between the two groups,especially in aphakic eyes, the corneal endothelium density went down quickly after the operation, and then increase over time. When silicon oil contacted the cornea, corneal endothelium density was significantly reduced（ P = 0, 000 ） and characteristic appearance was shown under specular microscope. Conclution Silicone oil in the anterior chamber may seriously damage corneal tissue by their directly contacting.