Legler U, Seiberth V, Knorz M C, Jung E, Liesenhoff H
Augenklinik, Universität Heidelberg, Fakultät für Klinische Medizin Mannheim.
Fortschr Ophthalmol. 1990;87(3):290-3.
Endothelial cell loss contributes to severe corneal decompensation following pars plana vitrectomy and silicone oil injection into the vitreous cavity. The corneal endothelium of 35 eyes (35 patients) was evaluated prospectively before and after pars plana vitrectomy in a clinical study by means of wide field specular microscopy (Roberts and Koester). Special attention was paid to differences between patients with and without silicone oil in the anterior chamber with respect to postoperative complications and endothelial cell loss. In 12 of the 35 eyes silicone oil was present in the anterior chamber. After a 6-month follow-up we found in all 35 eyes an average decrease in endothelial cell density of 22.9% +/- 13.3% compared to the preoperative values. A correlation between pre- and postoperative cell density (r = 0.827) after six months could be demonstrated. Logistic regression was used to estimate the statistical significance of various factors influencing endothelial cell loss such as inflammatory anterior chamber reaction, elevated intraocular pressure and silicone oil in the anterior chamber. Silicone oil in the anterior chamber was proved to be the main factor causing endothelial cell loss (p less than 0.025). Age group and number of previous intraocular surgical procedures showed no significant influence on endothelial cell loss.
玻璃体切除联合玻璃体腔硅油注入术后，内皮细胞丢失会导致严重的角膜失代偿。在一项临床研究中，采用广角镜面显微镜检查法（罗伯茨和凯斯特）对35只眼（35例患者）的角膜内皮在玻璃体切除术前和术后进行了前瞻性评估。特别关注了前房中有硅油和无前房硅油的患者在术后并发症和内皮细胞丢失方面的差异。35只眼中有12只眼前房中有硅油。经过6个月的随访，我们发现所有35只眼的内皮细胞密度与术前值相比平均下降了22.9%±13.3%。术后6个月时术前和术后细胞密度之间的相关性（r = 0.827）得以证实。采用逻辑回归分析来评估影响内皮细胞丢失的各种因素的统计学意义，如前房炎症反应、眼压升高和前房中有硅油。前房中有硅油被证明是导致内皮细胞丢失的主要因素（p<0.025）。年龄组和既往眼内手术次数对内皮细胞丢失无显著影响。
