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有晶状体眼和人工晶状体眼的玻璃体切除术及硅油注入术;角膜内皮变化

Pars plana vitrectomy and silicone oil injection in phakic and pseudophakic eyes; corneal endothelial changes.

作者信息

Farrahi Fereydoun, Feghhi Mostafa, Ostadian Farshad, Alivand Arash

机构信息

Department of Ophthalmology, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

J Ophthalmic Vis Res. 2014 Jul-Sep;9(3):310-3. doi: 10.4103/2008-322X.143361.

Abstract

PURPOSE

To evaluate the effect of silicone oil (SO) on the corneal endothelium in SO filled phakic and pseudophakic vitrectomizied eyes.

METHODS

This prospective comparative consecutive case-control study evaluated the corneal endothelial characteristics of 64 SO filled vitrectomizied eyes (case group) as compared to 46 vitrectomizied eyes without SO injection (control group). Endothelial cell densities (ECD), coefficient of variation (CV), and percentage of hexagonal cells (hexagonality) at the corneal center were evaluated preoperatively, 1 month and 6 months after surgery using noncontact specular microscopy and were compared between the two groups. Exclusion criteria were previous vitreoretinal surgery, aphakia, any degree of anterior chamber inflammation, SO bubbles in the anterior chamber and increased intraocular pressure in the postoperative period.

RESULTS

Six months after SO injection, mean ECD was 2,438.2±327.6 cell/mm(2) in the case group and 2,462.6±361.7 cell/mm(2) in the control group (P = 0.714) and mean hexagonality was 49.6 ± 6.8 and 54.6 ± 8.9, in the case and control groups, respectively (P = 0.004). Six months after operation, CV in the case group was 39.3 ± 5.6 and that in the control group was 35.7 ± 6.4 (P = 0.003).

CONCLUSION

Although the presence of SO in the vitreous cavity of phakic and pseudophakic eyes causes slight reduction in the number of endothelial cells, however it leads to significant changes in endothelial cell morphology. Thus, removal of SO after reaching the desired tamponade effect is recommended.

摘要

目的

评估硅油(SO)对填充硅油的有晶状体眼和人工晶状体眼玻璃体切除术后角膜内皮的影响。

方法

这项前瞻性比较连续性病例对照研究评估了64只填充硅油的玻璃体切除术后眼(病例组)与46只未注射硅油的玻璃体切除术后眼(对照组)的角膜内皮特征。术前、术后1个月和6个月使用非接触式镜面显微镜评估角膜中央的内皮细胞密度(ECD)、变异系数(CV)和六边形细胞百分比(六角形度),并在两组之间进行比较。排除标准为既往玻璃体视网膜手术史、无晶状体眼、任何程度的前房炎症、前房内硅油气泡以及术后眼压升高。

结果

注射硅油6个月后,病例组平均ECD为2438.2±327.6个细胞/mm²,对照组为2462.6±361.7个细胞/mm²(P = 0.714);病例组和对照组的平均六角形度分别为49.6±6.8和54.6±8.9(P = 0.004)。术后6个月,病例组CV为39.3±5.6,对照组为35.7±6.4(P = 0.003)。

结论

尽管有晶状体眼和人工晶状体眼玻璃体腔中存在硅油会导致内皮细胞数量略有减少,但会导致内皮细胞形态发生显著变化。因此,建议在达到所需的填塞效果后取出硅油。

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