Kasikci Murat, Sul Sabahattin, Simsek Huseyin Cem, Karalezli Aylin, Simsek Merve, Korkmaz Safak
Department of Ophthalmology, Mugla Sitki Kocman University Education and Research Hospital, Mugla, Turkey.
Department of Ophthalmology, Mugla Sitki Kocman University School of Medicine, Mugla, Turkey.
Curr Eye Res. 2023 Aug;48(8):704-711. doi: 10.1080/02713683.2023.2202366. Epub 2023 Apr 20.
This study evaluated the corneal endothelium, stromal keratocytes, subbasal nerve number and density in patients with silicone oil transferred to the anterior camera after pseudophakic complicated retinal detachment surgery by laser scanning confocal microscopy (IVLSCM).
Sequential measurements were made by IVLSCM between 3-6 months after surgery in two groups of patients: a) with silicon oil migration (Group 1) and without silicone oil migration (Group 2).
A total of 63 cases (Group 1: 32 and Group 2: 31) were examined. The mean ages of patients were 65 ± 12 and 61 ± 11 and M/F ratio was 18/14 and 17/14, respectively. Mean intraocular pressures were 16.60 ± 4.60 and 15.75 ± 5.70 mm Hg, respectively. Changes were detected by IVLSCM mostly on the superior part of the cornea. A significant decrease in endothelial cell density and the number was detected in group 1 (2072 ± 116.2 cells/mm 2752 ± 512.3 cells/mm; < 0.001). Significant increases in posterior keratocyte density and stromal hyperreflective deposits were observed in group 1 (887 ± 45.8 cells/mm 725 ± 65.8 cells/mm; < 0.001). A significant negative correlation was observed between the size of stromal deposits and endothelial cell density (=-0.758; < 0.001). The number and density of corneal subbasal nerves were significantly lower in group 1 (1.8 ± 0.8 and 4.8 ± 1.2 420 ± 101 and 701 ± 112 µm/square; < 0.001).
IVLSCM is a useful tool for the early detection of corneal abnormalities caused by silicone oil injection. This study verified silicone oil's detrimental effect on the corneal endothelium and revealed stromal changes in the anterior chamber, which we believe can be also been associated with the presence of silicone oil.
本研究通过激光扫描共聚焦显微镜(IVLSCM)评估了人工晶状体植入术后复杂性视网膜脱离手术中硅油转移至前房的患者的角膜内皮细胞、基质角膜细胞、基底膜下神经数量和密度。
对两组患者在术后3 - 6个月期间通过IVLSCM进行连续测量:a)有硅油迁移的患者(第1组)和无硅油迁移的患者(第2组)。
共检查了63例患者(第1组:32例,第2组:31例)。患者的平均年龄分别为65±12岁和61±11岁,男女比例分别为18/14和17/14。平均眼压分别为16.60±4.60和15.75±5.70 mmHg。IVLSCM检测到的变化主要发生在角膜上部。第1组内皮细胞密度和数量显著降低(2072±116.2个细胞/mm²对2752±512.3个细胞/mm²;P<0.001)。第1组后基质角膜细胞密度和基质高反射沉积物显著增加(887±45.8个细胞/mm²对725±65.8个细胞/mm²;P<0.001)。观察到基质沉积物大小与内皮细胞密度之间存在显著负相关(r=-0.758;P<0.001)。第1组角膜基底膜下神经的数量和密度显著降低(1.8±0.8对4.8±1.2条/mm;420±101对701±112 µm/平方;P<0.001)。
IVLSCM是早期检测硅油注射引起的角膜异常的有用工具。本研究证实了硅油对角膜内皮细胞的有害作用,并揭示了前房的基质变化,我们认为这也可能与硅油的存在有关。