Mitamura Y, Yamamoto S, Yamazaki S
Department of Ophthalmology, Toho University Sakura Hospital, Chiba, Japan.
Retina. 2000;20(1):59-62. doi: 10.1097/00006982-200001000-00011.
To assess prospectively the comeal endothelial damage associated with pars plana vitrectomy combined with lensectomy and gas tamponade.
The corneal endothelium was examined with a specular microscope preoperatively and 6 months postoperatively in 42 eyes that underwent pars plana vitrectomy combined with total lensectomy and gas tamponade with SF6 (19 eyes) or C3F8 (23 eyes), and in 12 control eyes that underwent vitrectomy combined with anterior capsule-preserved lensectomy and gas tamponade.
The mean +/- SD endothelial cell loss was 17.19+/-7.88% in the SF6 tamponade group, 27.54+/-10.57% in the C3F8 tamponade group, and 3.49+/-2.68% in the control group. Significant differences were found in the mean cell loss among these three groups. The degree of cell loss was significantly related to gas tamponade duration in the eyes with total lensectomy.
These results suggest that ophthalmic surgeons must try to preserve the lens capsule as much as possible in vitrectomy combined with lensectomy and long-acting gas tamponade in order to prevent corneal endothelial damage.
前瞻性评估玻璃体切割联合晶状体切除及气体填充相关的角膜内皮损伤。
对42例行玻璃体切割联合晶状体全切除及用SF6（19眼）或C3F8（23眼）气体填充的患眼，以及12例行玻璃体切割联合保留晶状体前囊的晶状体切除及气体填充的对照眼，术前及术后6个月用角膜内皮镜检查角膜内皮。
SF6填充组平均内皮细胞丢失率为17.19±7.88%，C3F8填充组为27.54±10.57%，对照组为3.49±2.68%。三组间平均细胞丢失率有显著差异。在晶状体全切除的患眼中，细胞丢失程度与气体填充时间显著相关。
这些结果表明，眼科医生在玻璃体切割联合晶状体切除及长效气体填充时，必须尽可能保留晶状体囊膜，以防止角膜内皮损伤。
