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不同眼内填充物玻璃体切除术后角膜内皮细胞丢失情况的评估

Evaluation of corneal endothelial cell loss following vitrectomy with different endotamponades.

作者信息

Rani Kirti, Solanki Anil, Agarwal Neha, Jha Shashi Nath, Aggarwal Ritika

机构信息

Department of Ophthalmology, Sir Ganga Ram Hospital, New Delhi, India.

Department of Vitreo-Retinal Surgery, Sir Ganga Ram Hospital, New Delhi, India.

出版信息

Oman J Ophthalmol. 2025 Jun 24;18(2):150-154. doi: 10.4103/ojo.ojo_258_24. eCollection 2025 May-Aug.

Abstract

CONTEXT

Ensuring functional corneal endothelium is imperative for achieving optimal surgical outcomes following successful vitreoretinal surgery. Despite the critical role of the corneal endothelium in postoperative recovery, limited research has addressed endothelial cell damage specifically attributed to vitreoretinal procedures. This knowledge gap necessitates further investigations to better understand the potential loss of corneal endothelial cells (CECs) associated with vitreoretinal surgery.

AIMS

To evaluate the effect of vitreoretinal surgery on CECs by using different endotamponading agents.

SETTINGS AND DESIGN

Prospective, nonrandomized, comparative, and observational study.

SUBJECTS AND METHODS

Patients ( = 32) were divided into three groups: C3F8 gas (Group A), silicone oil (Group B), and Ringer Lactate (Group C). Corneal endothelial parameters including, the corneal endothelial cell density (ECD), average cell area (AVG), coefficient of variation (CV), central corneal thickness (CCT), and percentage of hexagonal cells (HEX) were assessed preoperatively, at 1 month, and 3 month postsurgery.

STATISTICAL ANALYSIS USED

SPSS software version 16.0, Kolmogorov-Smirnov, Wilcoxon, and Chi-square tests were used. Statistical significance was set at < 0.05.

RESULTS

Significant differences in the changes in ECD and CCT were observed between the groups ( > 0.05). However, AVG, CV and HEX were not significantly different between the groups. No significant differences in the changes in endothelial cell parameters were noted between phakic and pseudophakic eyes.

CONCLUSIONS

CEC damage following vitrectomy with different endotamponades is a crucial consideration in vitreoretinal surgery. Vitreoretinal surgeons must carefully weigh the benefits and risks associated with different tamponade agents to safeguard corneal health in vitreoretinal surgeries.

摘要

背景

确保功能性角膜内皮对于玻璃体视网膜手术成功后实现最佳手术效果至关重要。尽管角膜内皮在术后恢复中起着关键作用,但针对玻璃体视网膜手术特有的内皮细胞损伤的研究有限。这一知识空白需要进一步研究,以更好地了解与玻璃体视网膜手术相关的角膜内皮细胞(CEC)潜在损失。

目的

通过使用不同的眼内填充剂评估玻璃体视网膜手术对CEC的影响。

设置与设计

前瞻性、非随机、对比性观察研究。

对象与方法

32例患者分为三组:C3F8气体组(A组)、硅油组(B组)和乳酸林格液组(C组)。术前、术后1个月和3个月评估角膜内皮参数,包括角膜内皮细胞密度(ECD)、平均细胞面积(AVG)、变异系数(CV)、中央角膜厚度(CCT)和六边形细胞百分比(HEX)。

所用统计分析方法

使用SPSS软件16.0版,采用Kolmogorov-Smirnov检验、Wilcoxon检验和卡方检验。设定统计学显著性水平为P<0.05。

结果

各组之间ECD和CCT变化存在显著差异(P>0.05)。然而,AVG、CV和HEX在各组之间无显著差异。有晶状体眼和无晶状体眼在内皮细胞参数变化方面无显著差异。

结论

玻璃体切除联合不同眼内填充剂后的CEC损伤是玻璃体视网膜手术中一个关键的考虑因素。玻璃体视网膜外科医生必须仔细权衡不同填充剂相关的利弊,以在玻璃体视网膜手术中保护角膜健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c118/12258856/844b8da33220/OJO-18-150-g001.jpg

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