经后路白内障摘除预防角膜内皮失代偿的疗效观察

目的观察经后路白内障摘除对预防角膜内皮失代偿的效果。方法对13例伴有严重角膜内皮异常但保持屈光透明的白内障患者行经后路白内障摘除术,并对术后矫正视力、主要并发症及角膜内皮密度进行评估,术后随诊8～28个月。结果 13例患者手术顺利,除1例患者因Fuch’s角膜内皮营养不良继发大泡性角膜病变于术后5个月矫正视力下降外,余患者术后矫正视力均有不同程度提高。术前、术后角膜内皮细胞平均密度比较差异无统计学意义(P>0.05)。结论经后路白内障摘除可最大程度减少医源性角膜内皮损伤,是伴有严重角膜内皮病变白内障患者安全、有效的手术方式。

Clinical effecacy of pars plana lensectomy on cataract combined with severely abnormal corneal endothelium

Objective To evaluate the clinical effecacy of pars plana lensectomy on cataract combined with severely abnormal corneal endothelium.Methods Pars plana lensectomy and pars plana vitrecomy were performed in all 13 cataract cases(5 women,8 men;13 eyes) with abnormal corneal endothelium but still transparent cornea.Phacofragmentation,intraocular lens implantation,retinal photocoagulation or C3F8 tamponade were chosen according to different cases.The best corrected visual acuity(BCVA) and the amount of the corneal endothelium were observed before surgery and 1 week,1 month and 6 month after surgery.Results BCVA improved in all patients after surgery,except for one patient with Fuch′s endothelial dystrophy,in whom BCVA turned worse after surgery and eventually cornea endothelium decompensation occurred.No significant difference in the mean density of corneal endothelial cells was found between before and after operation(P>0.05).No patient had retinal detachment.Conclusion Pars plana lensectomy,which decreases surgically-induced damage to the corneal endothelium,is a safe and efficient treatment for cataract combined with severely abnormal corneal endothelium.