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玻璃体视网膜手术后前房内有硅油的患者角膜的共聚焦显微镜成像。

Confocal microscopy imaging of the cornea in patients with silicone oil in the anterior chamber after vitreoretinal surgery.

作者信息

Szaflik Jacek P, Kmera-Muszyńska Maria

机构信息

Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2007 Feb;245(2):210-4. doi: 10.1007/s00417-006-0433-0.

Abstract

OBJECTIVE

Evaluation of corneal morphology by confocal microscopy after vitreoretinal surgery complicated by passage of silicone oil into the anterior chamber. Design Case series (case control study).

METHODS

Eight patients (eight eyes) who had undergone vitreoretinal surgery and had silicone oil in the anterior chamber but no clinically evident corneal abnormalities made up the patient group. The control group consisted of eight patients (eight eyes) who had undergone vitreoretinal surgery with application of silicone oil tamponade but who had no silicone oil clinically observable in the anterior chamber. In vivo examination of the cornea using a ConfoScan 3 (Nidek Technologies) confocal microscope equipped with the standard 40x immersion lens was performed. Central, upper, and lower parts of the cornea were assessed separately. High-magnification evaluation of the status of corneal layers and endothelial cell density in upper parts of the cornea directly in contact with silicone oil in the anterior chamber and in parts of the cornea not in direct contact with silicone oil was carried out.

RESULTS

Alterations in corneal morphology, especially in endothelium and posterior and medium stroma, were observed. In all cases, changes were more advanced in the upper part of the cornea. Endothelial cell density was significantly decreased in upper parts of the cornea.

CONCLUSIONS

In patients with silicone oil in the anterior chamber, confocal microscopy imaging reveals early morphological alterations of the cornea before their clinical manifestation.

摘要

目的

评估玻璃体视网膜手术后硅油进入前房所致并发症的共焦显微镜下角膜形态。设计:病例系列(病例对照研究)。

方法

患者组由8例(8只眼)接受玻璃体视网膜手术且前房有硅油但无临床明显角膜异常的患者组成。对照组由8例(8只眼)接受硅油填充玻璃体视网膜手术但前房临床未观察到硅油的患者组成。使用配备标准40倍浸没式物镜的ConfoScan 3(尼德克科技公司)共焦显微镜对角膜进行活体检查。分别评估角膜的中央、上部和下部。对前房与硅油直接接触的角膜上部以及未与硅油直接接触的角膜部分进行角膜各层状态和内皮细胞密度的高倍评估。

结果

观察到角膜形态改变,尤其是内皮以及后弹力层和中基质层。在所有病例中,角膜上部的改变更明显。角膜上部的内皮细胞密度显著降低。

结论

在前房有硅油的患者中,共焦显微镜成像可在角膜形态改变出现临床表现之前揭示其早期形态学改变。

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