玻璃体切除术后非直接损伤导致白内障的形成机制和防治对策

Pathogenesis and Prevention Strategies of Indirect Injured Cataract Format ion after Vitrectomy

玻璃体切除术已广泛应用于临床,尤其在各种玻璃体疾病、视网膜疾病和眼外伤的救治过程中得到了广泛应用。流行病学资料表明玻璃体切除术后在非直接损伤晶状体的情况下,手术后核性白内障的发生率明显增高,其发生机制和有效的防治策略是该领域研究热点。研究结果表明:玻璃体切除术后白内障高发生率的主要机制包括玻璃体物理性/化学性变化、手术时间、患者年龄以及眼部疾患、玻璃体切除术后葡萄膜炎等因素,其中玻璃体切除术后晶状体氧分压升高,增加了晶状体周围氧暴露时间是主要因素。因此,术中采用降低氧浓度,术后使用锌?去铁草酰胺等措施以期减少白内障的发生率,为玻璃体手术后白内障的药物预防和治疗提供了新思路。眼科学报2007;23:252-256.

Vitrectomy has been widely used in medical practice, especially in treatment of diseases such as vitreous body diseases, retinal diseases and ocular injury. Epidemiological studies have indicated that under the circumstance of injuring the lens indirectly after vitrectomy, the incidence of nuclear cataract is obviously increasing, the mechanism and the prevention as well as cure of which is still the live topic in this field. Many studies had manifested that the main mechanism of the high incidence of cataract after vitrectomy included the physical and chemical changes of vitreous body, time of operation, age of patients, diseases of the eye, and uveitis after vitrectomy, etc. The most important factor is that vitrectomy increased oxygen exposure to the lens. Therefore, the measure of decreasing oxygen concentration and the treatment of Zinc-desferrioxamine may reduce the incidence of cataract, which provides a new way for the prevention and treatment of cataract after vitrectomy.