晶状体前囊膜下上皮细胞增殖性病变的临床病理分析

A pathological study of lens subcapsular epithelial proliferation

目的 观察晶状体前囊膜下上皮细胞增殖的组织病理学变化 ,并探讨其发生原因。方法 取不同病因致手术摘除的伴晶状体前囊膜下上皮细胞增殖的眼球标本 6 4例 ,其中眼外伤 36例 ,绝对期青光眼 10例 ,角巩膜葡萄肿 6例 ,视网膜母细胞瘤 5例 ,眼内炎 4例 ,白内障手术后 2例 ,糖尿病性白内障 1例 ,在光镜下进行组织病理学观察研究。结果 增殖的晶状体前囊膜下上皮细胞形态不规则、排列不整齐 ,向后囊膜下延伸 ;囊膜破裂或部分缺如者前囊膜下纤维结缔组织化生 ,纤维组织形成 ;晶状体纤维崩解、液化和钙化。结论 眼内多种病理状态 ,如眼外伤、眼内炎、青光眼 ,以及糖尿病等全身疾患均可使晶状体前囊膜下上皮细胞增殖 ,导致晶状体发生病变。眼内炎和眼外伤后晶状体发生增殖的程度最重。

Objective To observe the histopathological changes of lens subcapsular epithelial proliferation and analyze their etiology. Methods Sixty four enucleated eyes with lens subcapsular epithelial proliferation were observed with light microscopy and analyzed retrospectively. Among all the cases of lens subcapsular epithelial proliferation, there were 36 ones enucleated because of trauma, 10 absolute glaucoma, 6 corneoscleral staphyloma, 5 intraocular tumor, 2 after cataract extraction, 4 endophthalmitis, 1 cataract combined with ocular atrophy (diabetes type II). Results Proliferated lens subcapsular epithelial cells were atypical, irregularly arranged, and extended to the posterior subcapsule. In cases with lens capsular rupture or partial absence, there were subcapsular fibro connective tissue metaplasia, scar tissue formation, cortical collapse, local liquefaction and calcification. Conclusion Lens subcapsular epithelial proliferation is caused by some intraocular pathological conditions. In cases with endophthalmitis and ocular trauma, its severity is the most serious.