硅油填充术后眼压对角膜内皮细胞的影响及变化特点

Effect of intraocular pressure on corneal endothelial cells after silicone oil tamponade

目的:评估硅油填充术后眼压对角膜内皮细胞的影响及变化特点。方法:选取2019年1月1日至9月30日在佛山市第二人民医院眼科中心行玻璃体切除联合硅油注射的患者共131名,分为高眼压组(n=80)和正常眼压组(n=51)。高眼压组术后任意一次测眼压>21 mmHg,正常眼压组术后眼压均≤21 mmHg。比较填充硅油前与取硅油时的角膜内皮细胞参数测量值。结果:高眼压组的平均眼压为20.79 mmHg,正常眼压组的平均眼压为14.70 mmHg(P<0.001)。取硅油时,两组角膜内皮细胞密度(corneal endothelial cell density,ECD)均明显减少,平均内皮细胞面积均明显增大(P<0.05),高眼压组内皮细胞大小变异系数(coefficient of variation of endothelial cell size,CV)明显变大(P<0.05)。高眼压组ECD丢失率(6.3%)高于正常眼压组(3.5%);其中,高眼压组中术后1~6周内的眼压升高(7.1%)、眼压≥40 mmHg(7.3%)对角膜内皮细胞影响最大。ECD丢失与眼压变化有显著相关性(r=0.176,P=0.044)。结论:硅油填充后高眼压是角膜内皮细胞丢失的重要危险因素。

Objective:To evaluate the effect of intraocular pressure(IOP)on corneal endothelial cells after silicone oil tamponade.Methods:Patients(n=131)received vitrectomy with silicone oil injection in Ophthalmology Center in Second People’s Hospital of Foshan City from January 1st to September 30th 2019 were divided into the high IOP group(n=80)and normal IOP group(n=51).IOP was>21 mmHg at any time in the high IOP group and was≤21mmHg in the normal IOP group after surgery.The values of corneal endothelial cells before filling with silicone oil and before removing silicone oil were compared.Results:The average IOP was 20.79 mmHg in the high IOP group,and 14.70 mmHg in the normal IOP group(P<0.001).The number of endothelial cells(ECD)was reduced,but the average endothelial cell area was increased(P<0.05)in both groups.The coefficient of variation of endothelial cell size in high IOP group was increased(P<0.05).ECD loss rate was 6.3%in the high IOP group and 3.5%in normal IOP group.Increased IOP within 1-6 weeks after surgery(7.1%)and IOP≥40 mmHg(7.3%)had the greatest impact on ECD.ECD loss was correlated with IOP(r=0.176,P=0.044).Conclusion:High intraocular pressure after silicone oil filling is an important risk factor for the loss of corneal endothelial cells.