眼内炎患者硅油充填前房后眼压升高对角膜内皮的影响

The influence of ocular hypertension to corneal endothelium in eyes of endophthalmitis with forward migration of silicone oil into the anterior chamber

目的评价眼内炎玻璃体切除术后硅油充填前房后眼压升高对角膜内皮细胞计数的影响。设计回顾性病例系列研究。研究对象2006年11月至2011年11月于北京同仁医院眼科中心眼外伤组就诊的眼内炎患者19例(19眼)均行晶状体玻璃体切除联合硅油注入术,术后硅油完全充填前房。方法对19例(19眼)患者行硅油取出术。依据硅油取出术前眼压分组:眼压>21 mm Hg为高眼压组(A组)(12眼);眼压≤21 mm Hg为正常眼压及低眼压组(B组)(7眼)。硅油取出术后1个月行角膜内皮细胞计数检查,并进行统计学分析。主要指标硅油取出术前眼压及硅油取出术后1个月角膜内皮细胞密度。结果硅油取出术后1个月,角膜内皮细胞密度≥1000个/mm2者:A组2眼(2/12,16.7%),B组5眼(5/7,71.4%);角膜内皮细胞密度<1000个/mm2者:A组10眼(10/12,83.3%),B组2眼(2/7,28.6%);两组比较差异有统计学意义(P=0.045)。角膜内皮细胞密度≥1400个/mm2者:A组1眼(1/12,8.3%),B组5眼(5/7,71.4%);角膜内皮细胞密度<1400个/mm2者:A组11眼(11/12,91.6%),B组2眼(2/7,28.6%)。两组比较差异具有统计学意义(P=0.01)。结论硅油充填前房合并眼压升高可以导致角膜内皮细胞严重丢失。

Objective To evaluate the influence of ocular hypertension to corneal endothelium cell density in eyes with forward migration of silicone oil into the anterior chamber in treated endophthalmitis with vitrectomy. Design Retrospective case series. Partici- pants 19 eyes of 19 cases with endophthalmitis after surgery of lens extraction, vitreetomy and silicone oil tamponade from Nov. 2006 to Nov. 2011 in Beijing Tongren Hospital. Method All the eyes were filled with silicone oil after vitrectomy. According to intraocular pressure before silicone oil removal from Nov 2006 to Nov 2011 in Beijing Tongren Hospital, 19 eyes were classified into two groups： group A （IOP〉21 mm Hg） 12 eyes and group B （IOP〈21 mm Hg） 7 eyes. The corneal endothelial cell densities of 19 eyes were observed 1 month after removal of silicone oil. Main Outcome Measures IOP and corneal endothelial cell densities. Results One month after removal of silicone oil, corneal endothelial cell densities≥ 1000/mm2 was found in 2 cases of group A （2/12, 16.7%）, 5 cases of group B（5/7, 71.4%）; corneal endothelial cell densities 〈1000/mm2 was found in 10 cases of group A（10/12, 83.3%）, 2 cases of group B （2/7, 28.6%）. The difference was significant （P=-0.045）. The corneal endothelial cell densities≥ 1400/ram2 was found in 1 case of group A （1/12, 8.3%）, 5 cases of group B （5/7, 71.4%） respectively; corneal endothelial cell densities〈1400/mm2 was found in 11 cases of groupA （11/12, 91.6%）, 2 cases of group B（2/7, 28.6%）. The difference was significant （P=0.01）. Conclusion The high ocular hypertension in eyes with forward migration of silicone oil into the anterior chamber may cause great damage to corneal endothelial cell densities.