Breebaart A C, Nuyts R M, Pels E, Edelhauser H F, Verbraak F D
Department of Ophthalmology, University of Amsterdam, The Netherlands.
Arch Ophthalmol. 1990 Aug;108(8):1121-5. doi: 10.1001/archopht.1990.01070100077038.
Eighteen patients developed an acute corneal decompensation following normal intraocular surgery (cataract extraction in 17 patients), characterized by star-shaped endothelial folds, a twofold increase in corneal thickness, and a visual acuity of counting fingers during several postoperative days. In some cases, there was an additional iritis and transient hypotony. There was no effect of topical and/or subconjunctival corticosteroids on the course of the decompensation. Endothelial morphometric analysis showed a mean endothelial cell loss of 72%. Endothelial wound healing, as determined by coefficient of variation and percentage hexagonals, stabilized 6 months postoperatively. We coined the term toxic endothelial cell destruction for this syndrome. Epidemiological evaluation revealed the toxic endothelial cell destruction syndrome to be linked with the 10-fold increase of a detergent solution in the ultrasonic bath for cleaning the surgical instruments.
18例患者在常规眼内手术后发生急性角膜失代偿（17例为白内障摘除术），其特征为星状内皮褶皱、角膜厚度增加两倍以及术后数天内视力仅为指数。部分病例还伴有虹膜炎和短暂性低眼压。局部及/或结膜下使用皮质类固醇对失代偿病程无影响。内皮细胞形态计量分析显示内皮细胞平均损失72%。通过变异系数和六边形百分比测定的内皮伤口愈合情况在术后6个月稳定。我们将此综合征命名为毒性内皮细胞破坏。流行病学评估显示，毒性内皮细胞破坏综合征与用于清洁手术器械的超声清洗槽中一种洗涤剂溶液用量增加10倍有关。
