中华眼科杂志 1999年第2期第35卷 论 著
作者：王海燕 李立新 黎晓新
单位：100044 北京医科大学人民医院眼科［王海燕(研究生，现在北京同仁医院眼科，100730)、李立新、黎晓新
关键词：角膜内皮；晶体；玻璃体切除
【摘要】 目的 探讨玻璃体手术中摘除晶体对角膜内皮的损伤作用，以便为手术方式的选择提供依据。方法 观察179只眼行玻璃体、视网膜手术前、术后2周、4周、8周、3个月及6个月的角膜内皮细胞密度变化。结果 有晶体眼行玻璃体切除术、玻璃体切除＋硅油填充术及玻璃体切除＋六氟化硫(sulfur hexafluoride, SF6)注入术，术后角膜内皮细胞密度与术前相比差异无显著性。玻璃体切除＋晶体摘除术后角膜内皮细胞密度显著降低。无晶体眼及人工晶体眼行玻璃体、视网膜手术，术前、后角膜内皮细胞密度虽差异无显著性，但呈现一下降趋势。结论 玻璃体切除＋晶体摘除术将损伤角膜内皮；无晶体眼及人工晶体眼行玻璃体、视网膜手术有一定的危险性。为保护角膜内皮，行玻璃体、视网膜手术时应尽可能保留晶体。
The effect of extracting lens on damage of corneal endothelium in vitreous surgery WANG Haiyan, LI Lixin, LI Xiaoxin. Department of Ophthalmology, People's Hospital, Beijing Medical University, Beijing 100044
【Abstract】 Objective To observe the effect of extracting lens on the damage of corneal endothelium in vitreous and retinal surgery.Methods The corneal endothelial cell densities of 179 eyes were observed preoperatively and at postoperative 2, 4, 8 weeks and 3 and 6 months.Results Postoperatively, there was no significant change of the corneal endothelial cell densities compared with that of the preoperative ones in phakic eyes among different operations. There was also no significant change of the cell densities, but an tendency of cell loss in the aphakic and pseudophakic eyes after vitreous and retinal surgery. The corneal endothelial cell densities decreased significantly after vitrectomy with lensectomy.Conclusions It is the vitrectomy with lensectomy that makes the corneal endothelial damage. Vitreous and retinal surgery poses a risk to corneal endothelium in the aphakic and pseudophakic eyes.
【Key words】 Corneal endothelium Lens Vitrectomy
随着晶体摘除和玻璃体、视网膜手术的逐步开展，玻璃体切除、玻璃体切除＋晶体摘除及玻璃体腔内注入各种填充物，常使部分患者术后出现角膜内皮失代偿现象。我们对行晶体、玻璃体、视网膜手术的患者手术前后的角膜内皮进行了系统的观察，旨在探讨玻璃体、视网膜手术中摘除晶体对角膜内皮的损伤作用, 以便为手术方式的选择提供依据。
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