Wenzel M, Caspers S, Saari K M, Hayes P, Reim M
Augenklinik, RWTH Aachen.
Ophthalmologe. 1995 Jun;92(3):284-8.
In the early postoperative stage giant cells often appear on IOLs. Independent of this, a foreign-body reaction may start about 3 months after surgery from posterior synechia. Foreign-body reaction occur more frequently in diabetic patients or patients with glaucoma. In a prospective trial, we examined the surface of the IOLs from 115 patients with diabetes or glaucoma using specular microscopy. We compared the maximal density of the cells to visual acuity. One week and 1 month after surgery, the maximal density of giant cells was between 0 und 20/mm2; vision (median) was independent of the giant cell density in all groups between 20/25 and 20/30. Three months after surgery, the maximal density of giant cells was between 0 und 35/mm2; vision (median) was 20/25 in patients with no giant cells or cell densities up to 15/mm2. Seven patients had cell densities between 16 and 35/mm2; visual acuity (median) was 20/125. The difference was significance was (P < or = 0.05). Six months and 1 year later after surgery, the maximal density of giant cells was between 0 and 41/mm2; the vision (median) in patients with giant cell densities up to 15/mm2 was between 20/20 and 20/25. In five examinations the cell densities were found to be in the range of 16 to 40/mm2; visual acuity (median) was 20/80 in these cases. The difference is not significant (P < or = 0.05). A foreign-body reaction with more than 15 giant cells/mm2 is a rare complication of cataract surgery with lens implantation. Three months after surgery, this complication correlates with poor vision.
在术后早期，巨细胞常出现在人工晶状体上。除此之外，异物反应可能在手术后约3个月因虹膜后粘连而开始。异物反应在糖尿病患者或青光眼患者中更常见。在一项前瞻性试验中，我们使用镜面显微镜检查了115例糖尿病或青光眼患者的人工晶状体表面。我们将细胞的最大密度与视力进行了比较。手术后1周和1个月，巨细胞的最大密度在0至20/mm²之间；在所有视力介于20/25至20/30之间的组中，视力（中位数）与巨细胞密度无关。手术后3个月，巨细胞的最大密度在0至35/mm²之间；在无巨细胞或细胞密度高达15/mm²的患者中，视力（中位数）为20/25。7例患者的细胞密度在16至35/mm²之间；视力（中位数）为20/125。差异具有统计学意义（P≤0.05）。手术后6个月和1年，巨细胞的最大密度在0至41/mm²之间；巨细胞密度高达15/mm²的患者的视力（中位数）在20/20至20/25之间。在5次检查中，发现细胞密度在16至40/mm²范围内；这些病例的视力（中位数）为20/80。差异无统计学意义（P≤0.05）。每平方毫米有超过15个巨细胞的异物反应是白内障手术联合晶状体植入的一种罕见并发症。手术后3个月，这种并发症与视力不佳相关。
