有晶体眼前房负镜片植入术角膜内皮观察

The change of corneal endothelium from anterior chamber intraocular lenses in phakic myopic eyes

目的 :观察有晶体眼植入前房负镜片矫正高度近视术后角膜内皮变化。方法 :14眼手术 ,13眼随访 2 4月。术前及术后 3月、6月、 12月、 2 4月检查角膜内皮密度 ,内皮形态及有否内皮黑区 ,对比观察内皮变化 ,另有 3眼 RK,4眼未手术眼同样作内皮检查对照。结果 :13眼术前内皮密度 2 5 44± 2 2 7/ mm3,术后 3月 2 34 1/ mm2 ,术后 6月 2 36 5 / mm2 ,术后 12月 2 42 2 / mm2 ,术后 2 4月 2 35 8± 15 2 / mm2。分别比术前下降 8.0 %、 7.4%、 4.8%、 7.3%。皮内形态和内皮黑区无变化。随访 2 4月 RK组内皮密度下降6 .5 % ,未手术组内皮密度下降 1.7%。结论 :有晶体眼前房镜片植入术矫正高度近视 ,术后角膜内皮密度有所下降 ,下降幅度 10 %左右。但本组病例数较少 ,随访时间欠长 ,仅供参考。术后近期内皮密度下降主要与手术有关 ,而术后远期内皮密度下降可能与眼内慢性炎症、镜片及房水循环有关。

Objective:To observe the corneal endothelium of high myopia phakic eyes after implant anterior chamber lense.Method:14 eyes had operations and 13 eyes follow up 24 monthes,preoperation and three monthes,six monthes,one year,tow years after operations examinated the corneal endothelium of their density、shape as well as dark area.The contrast groups are 3 eyes RK and 4 eyes no operation.Results:13 eyes preoperation the average corneal endothelium density is 2544±227/mm 2,Follow up 3 monthes,6 monthes,12 monthes,24 monthes the density are 2341/mm 2,2365/mm 2,2422/mm 2,2358±152/mm 2,loss 8 0%,7 4%,4 8%,7 3%.Their shape and dark area have not change.The group of RK loss 6 5%,the group of no opertion loss 1 7%.Conclusion:The corneal endothelium losses in phakic myopic eyes implantation anterior cnahber lenses,the loss degree have been tolerable yet.But the number of this group patients too few and the time of follow up too short.The loss in 1 6 month relation to operation,and over 6 month,the loss relation to chronic inflammation,lens and the circulation of aqueous fluid in anterior chamber.