带虹膜隔人工晶状体植入对角膜内皮细胞及房角结构影响分析

The investigation of IOL with iris diaphragm implantation affected on corneal endothelium and anterior chamber angle

目的通过带虹膜隔人工晶状体植入后对角膜内皮细胞、前房深度及房角结构变化的研究，认为带虹膜隔人工晶状体植入是目前治疗外伤性虹膜缺损效果好且副反应小的方法。方法对2010年1月至2012年1月在潍坊市第二人民医院五官科就诊的20例外伤性虹膜缺损患者，均行玻璃体切割术3个月后再行睫状沟缝线固定带虹膜隔人工晶状体。患者术前和术后1周、1个月、3个月均采用角膜内皮显微镜检查角膜内皮细胞密度、UBM检查前房深度及房角。观察术前和术后1周、1个月、3个月角膜内皮细胞密度及前房深度、房角的变化。结果（1）带虹膜隔人工晶状体植入后，角膜内皮细胞密度降低，术后1周、1个月、3个月与术前比，术后1周、1个月、3个月两两相比，差异均无统计学意义（P〉0．05）。（2）带虹膜隔人T晶状体植入后前房深度变浅、房角变窄，与正常眼前房深度比较差异有统计学意义（P〈0．05）。结论（1）带虹膜隔人工晶状体植入术后，角膜内皮细胞密度降低，但与术前比较差异无统计学意义（P〉0．05）。（2）带虹膜隔人工晶状体植入术后前房变浅，房角变窄，与正常眼比较差异有统计学意义（P〈0．05）。UBM观察前房深度及房角无创伤且能早期发现房角异常，值得推广。

Objective To infer the traumatic iris coloboma＇s treatment of IOL with iris dia- phragm implantation effectively and with fewer side effect. Methods Twenty cases with traumatic iris coloboma were studied. All patients were implanted an IOL with iris diaphragm after vitrectomy 3 months later. With the help of comeal endothelial microscopy and UBM, the changes of corneal endothelial cell density, anterior chamber depth and angle on preoperation and postoperation 1 week, 1 month and 3 months were observed. Results After operation, the density of corneal endothelial cells fallen, but the difference was not statistically significant between 1 week, 1 month, 3 months and pre-operation, and no difference after pairwise comparisons on 1 week, 1 month and 3 months. After operation, anterior chamber depth became shallow and angle narrow. The difference was statisti- cally significant compared with normal anterior chamber depth. Conclusions After operation, the density of corneal endothelial cell fallen, but the difference is not statistically significant compared with pre-operation. After operation, anterior chamber depth become shallow and angle narrow. The difference is statistically significant compared with normal anterior chamber depth. UBM can provide a non-traumatic method for the examination on anterior chamber depth and angle, and find out the early abnormal performance of anterior chamber angle, it is worth popularizing.