硅油对角膜内皮的影响

The effect of silicone oil on corneal endothelium

目的：探讨硅油在不同情况下对角膜内皮的影响。方法：对１７０只眼行不同手术术前、术后２周、４周、８周及３个月时的角膜内皮细胞密度进行观察记录，同时对硅油入前房的２０只眼进行观察。结果：在眼压控制良好的情况下，有晶体眼行单纯玻璃体切割术及玻璃体切割硅油填充术，无晶体眼行玻璃体切割硅油填充术，有晶体眼及无晶体眼行硅油取出术手术后各期角膜内皮细胞密度与术前相比均无显著差异，有晶体眼行玻璃体切割晶体切割硅油填充术后角膜内皮细胞密度与术前相比显著降低，但术后各期角膜内皮细胞密度无显著差异。硅油入前房接触角膜内皮后角膜内皮细胞严重受损，细胞形态发生显著改变。结论：在眼压控制良好的情况下，无论有晶体眼或是无晶体眼行玻璃体切割硅油填充术或硅油取出术对角膜内皮细胞密度均无显著影响。有晶体眼行晶体切割玻璃体切割硅油填充术手术操作本身可造成角膜内皮的损伤，但术后角膜内皮细胞密度无进一步的降低，说明玻璃体腔内硅油对角膜内皮的损伤作用不显著。当硅油进入前房接触角膜内皮时会对角膜内皮细胞产生严重的不可逆的损伤。

The study was designed to observe the effect of silicone oil on corneal endothelium.The corneal endothelial cell densities (ECD) of 170 eyes with different operations were observed at preoperation,and postoperative 2,4,8 weeks,3 months respectively.At the same time,the corneal endothelial cell morphology of 20 eyes was also observed when silicone oil in the anterior chamber contacted directly the endothelial cell.While intraocular pressure (IOP) was controlled,there was no significant change of the postoperative ECD compared with the preoperative ECD in phakic eyes with simple vitrectomy and vitrectomy with silicone oil,aphakic eyes with vitrectomy with silicone oil,phakic and aphakic eyes with silicone removal.The ECD decreased significantly after vitrectomy with lentectomy with silicone oil,but postoperative ECD had no more decrease.The corneal endothelium was damaged seriously by directly contacting silicone oil in the anterior chamber.While intraocular pressure was controlled,there was no significant effect on the corneal endothelium in vitrectomy with silicone oil,or silicone oil removal in phakic and aphakic eyes.The corneal endothelium was damaged by vitrectomy with lentectomy with silicone oil,but postoperative ECD had no more decrease.The silicone oil in vitreous capacity had no damage on corneal endothelium.The effect was significant when silicone oil in the anterior chamber directly contacted the corneal endothelium.