角膜内皮细胞功能不良者人工晶状体植入临床观察

Clinical survey of intraocular lens implantation in the patients with the disfunction of corneal endothelium

目的探讨角膜内皮细胞功能不良者人工晶状体植入术的手术技巧及其疗效分析。方法对24例（24眼）角膜内皮细胞功能不良者分别采用二期人工晶状体植入术、超声乳化联合人T晶状体植入术、白内障现代囊外摘出联合人工晶状体植入术，观察术后视力及角膜内皮细胞计数，随访时间为术后1d、3d、1周、1个月，3个月，6个月。结果术后视力均较术前明显提高，脱盲率为91．7％，脱残率为75％，无角膜内皮细胞失代偿发生。结论对角膜内皮细胞功能不良者行白内障摘出联合人工晶状体植入时，选择适当的手术方式、高效能黏弹剂、高质量的灌注液，配备WhiteStar的超声乳仪及术者娴熟的手术技巧是手术成功，防止角膜内皮功能失代偿的的重要保障。

Objective To explore the technique of the intraocular lens （10L） implantation for the patients with disfunction of corneal endothelium and to analyze the treatment effect of the technique. Methods 24 cases （24 eyes）with the disfunction of corneal endothelium had been respectively undergone the secondary IOL implantation, phacoemulsification （phaco） combined with IOL implantation and extracapsular cataract extraction （ECCE） combined with IOL implantation. The number of corneal endothelium and the visual acuity of the patients had been recorded after operation. The patients were followed up on the 1 d, 3 d, 1 week, 1,3,6 month post-operatively. Results Compared with the visual acuity of pre-operation, the visual acuity of postoperation in all patients highly increased. The rate of out-of-blindness was 91.7% and the rate of out-of-disability was 75%. No patients had the decompensation of corneal endothelium. Conclusion To prevent the disfuncion of corneal endothelium, it is an important guarantee to choose the suitable style of operation, the better healon, top-quality infusion, White Star Phaco instrument and the skillfull surgeon when operating on the patients with disfunction of corneal endothelium.