Ohguro N, Matsuda M, Kinoshita S
Department of Ophthalmology, Osaka University Medical School, Japan.
Br J Ophthalmol. 1997 Dec;81(12):1056-9. doi: 10.1136/bjo.81.12.1056.
The morphological changes of the corneal endothelium after posterior chamber lens implantation in the transplanted corneas were investigated.
36 patients underwent extracapsular cataract extraction with posterior chamber lens implantation. Among these, penetrating keratoplasty had been performed in 18 patients before cataract surgery. The indications for penetrating keratoplasty in these cases included keratoconus, herpetic keratitis, and macula cornea. 18 cataract patients with normal corneas were also studied as controls. The central corneal endothelium in each subject was examined with a wide field specular microscope at a few days before and 3 months after cataract surgery.
Although the transplanted corneas showed lower endothelial cell densities, marked polymegethism, and pleomorphism in the baseline variables, the endothelial morphological changes in the transplanted corneas after posterior chamber lens implantation were comparable with those in the normal corneas. Also, there was no clinical evidence, especially, of corneal epithelial and/or endothelial rejections and corneal decompensation in all corneas.
Even though the transplanted corneas have a lower endothelial cell density and marked polymegethism, it is believed that cataract surgery does not induce corneal decompensation in cases where the peripheral recipient endothelium can be considered to have normal morphology.
研究移植角膜后房型人工晶状体植入术后角膜内皮的形态学变化。
36例患者接受了白内障囊外摘除联合后房型人工晶状体植入术。其中,18例患者在白内障手术前已行穿透性角膜移植术。这些病例中穿透性角膜移植术的适应证包括圆锥角膜、疱疹性角膜炎和角膜斑翳。另外18例角膜正常的白内障患者作为对照进行研究。在白内障手术前几天及术后3个月,用广角镜面显微镜检查每个受试者的中央角膜内皮。
虽然移植角膜在基线变量中显示出较低的内皮细胞密度、明显的大小不均一性和多形性,但后房型人工晶状体植入术后移植角膜的内皮形态学变化与正常角膜相当。此外,所有角膜均无临床证据表明存在角膜上皮和/或内皮排斥反应以及角膜失代偿。
尽管移植角膜的内皮细胞密度较低且有明显的大小不均一性,但据信在周边受体内皮形态可视为正常的情况下,白内障手术不会导致角膜失代偿。