摘要
目的分析白内障手术后角膜内皮失代偿的原因，证实Fuchs角膜内皮营养不良（FuchEndothelialDystrophy，FED）是白内障术前检查不可忽视的眼部疾病。方法回顾性系列病例研究。对2007年1月至2011年4月因白内障手术后角膜内皮失代偿于北京大学第三医院行角膜移植术的病例资料进行回顾性分析，记录白内障手术方式、人工晶状体类型及合并的眼部疾病。选取其中行单纯白内障摘除及后房型人工晶状体植人术者为研究对象，检查患者角膜情况，包括裂隙灯显微镜、共聚焦显微镜、角膜内皮镜、眼前节照相，确诊FED，计算FED的检出率。结果共收集85例患者，其中62例曾行单纯白内障摘除及后房型人工晶状体植入术，男性32例，女性30例，年龄19～85岁，确诊为FED的8例，男2例，女6例，年龄66～85岁，检出率为8％。角膜手术与白内障手术间隔为6个月至7年，首次角膜移植术7例，再次角膜移植术1例。确诊病例的裂隙灯下表现角膜内皮针尖大小、银箔样反光。共聚焦显微镜下见角膜内皮细胞密度降低，形态和大小不一，内皮面滴状赘疣形成。角膜内皮镜下见内皮黑区。结论FED是白内障术后角膜内皮失代偿的原因之一。白内障术前FED漏诊率较高，术前对患者进行角膜内皮的检查具有重要意义，可减少手术并发症。
Objective To investigate the etiology of corneal endothelial dysfunction after cataract surgery,verify that Fuch Endothelial Dystrophy （FED） should not be ignored. Methods The patients who were performed corneal transplantation because of corneal endothelial dysfunction after cataract surgery between January 2007 and April 2011 were enrolled in this study. Cataract surgery, IOL types and combined eye diseases were recorded. The cases who received simple cataract extraction and posterior chamber intraocular lens implantation were involved in this study. We checked the pa- tients by slit lamp microscopy, confocal microscopy, corneal endothelium microscopy and anterior seg- ment photography. Finally, FED was diagnosed, and calculated the detection rate. Results A total of 85 cases were collected, 62 cases received cataract extraction and posterior chamber intraocular lens implantation, including 32 males, 30 females, and 19-85 years old. Eight cases were diagnosed as FED,2 males, 6 females,and 66-85 years old. The interval between corneal surgery and cataract surgery was from 6 months to 7 years. Seven cases underwent initial corneal transplantation while 1 case changed graft. The FED detection rate was 8%. Conclusions FED may be one of the reasons of corneal endothelial dystrophy after cataract surgery. Therefore, preoperative examination of corneal endothelium is very important.
出处
《中国实用眼科杂志》
CSCD
北大核心
2012年第9期1071-1074,共4页
Chinese Journal of Practical Ophthalmology
