Brooks A M, Grant G, Gillies W E
Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.
Ophthalmology. 1990 Jan;97(1):85-9. doi: 10.1016/s0161-6420(90)32622-2.
Although phacolytic glaucoma is well known and the clinical picture is well recognized, the nature of the polychromatic hyperrefringent granules is less well understood. A series of five cases was examined by specular microscopy, and the anterior chamber aspirate obtained at operation was subsequently examined by direct microscopy of the wet aspirate. Direct microscopy showed that the macrophages identified histologically in the aspirate corresponded to regular round cells about three times the size of an erythrocyte seen in the relief mode of specular microscopy. This finding aided in the interpretation of cellular deposits seen on specular microscopy. One hyperrefringent granule was seen on the posterior endothelium on specular microscopy, and results of subsequent examination of the aspirate showed this and the crystals in another patient to be morphologically identical with cholesterol crystals. The findings confirm that cholesterol crystals are present in the exudate in phacolytic glaucoma and are responsible for hyperrefrigent granules.
尽管晶状体溶解性青光眼广为人知且其临床表现也已得到充分认识，但多色性高折光颗粒的本质却了解得较少。我们通过镜面显微镜检查了一系列五例病例，并随后对手术时获取的前房吸出物进行湿片直接显微镜检查。直接显微镜检查显示，吸出物中经组织学鉴定的巨噬细胞对应于在镜面显微镜浮雕模式下所见的约为红细胞三倍大小的规则圆形细胞。这一发现有助于解释镜面显微镜下所见的细胞沉积物。在镜面显微镜下，在后弹力层内皮上可见一个高折光颗粒，随后对吸出物的检查结果显示，该颗粒以及另一例患者中的晶体在形态上与胆固醇晶体相同。这些发现证实，胆固醇晶体存在于晶状体溶解性青光眼的渗出物中，并是高折光颗粒的成因。
