虹膜固定型屈光性人工晶状体植入术对角膜内皮细胞的影响

目的 评价虹膜固定型屈光性人工晶状体植入术对患者角膜内皮细胞的影响。方法我院采用虹膜固定型屈光性人工晶状体植入术治疗高度近视患者12例（19眼）。分别于术前、术后3个月及6个月，检测所有患者角膜内皮细胞计数、计算角膜内皮丢失率以及人工晶状体与角膜的距离，并作比较分析。结果所有患眼均手术成功．术后第1天11眼角膜透明，8眼角膜上皮轻度水肿，经局部及全身糖皮质激素对症治疗后，于术后3～5d消退；术后随访6个月，所有患者角膜均透明。术后3、6个月角膜内皮计数[（2783±214）、（2749±232）个／mm^2）]均较术前[（2937±196）个／mm^2]明显减少（均P〈0．05）；而术后6个月角膜内皮计数、角膜内皮丢失率[（5．76±0.23）％]以及人工晶状体与角膜的距离[（2．69±037）mm]与术前3个月[（5．24±0．11）％、（2．73±0．18）mm]均无明显差异（均P〉0．05）。结论虹膜固定型屈光性人工晶状体植入术后，角膜内皮细胞近期存在丢失现象，但3个月后趋于稳定，中远期效果尚需进一步观察和研究。

The influence of the implantation of the iris-claw lens in phakic eyes on the corneal endothelial cell density in patients with high myopia

Objective To evaluate the influence of iris fixed refractive lens implantation on the corneal endothelial cell density in patients with high myopia, Methods Twelve cases （19 eyes） of high myopia received the Verisyse iris-claw phakic intraocular lens （IOL） implantation. They were followed up for 6 months. The corneal endothelial cell density were observed before and at 3 and 6 month after operation. Results All 19 eyes were implanted successfully. Compare with that before operation, the mean corneal endothelial cell density and at 3, 6 month of operation was significantay decreased （P〈0.05）; but there were no significant differences between 3 months and 6 months （P〉0.05）. Postoperatively the mean corneal endothelial cell loss rate at 3 months and 6 months was （5.24 ± 0. 11 ）% and （ 5.76± 0.23 ）%. Conclusion Corneal endothelial cells are lost shortly after fixed-iris lens implantation, but reaches stabilization after three month of operation. Its long-term effects need to be further studied.