内眼手术后角膜后弹力层脱离的临床分析

目的：探讨白内障超声乳化联合人工晶状体植入术、白内障囊外摘除联合人工晶状体植入术、青光眼小梁切除术三种手术后角膜后弹力层脱离的原因及处理方法。
　　方法：回顾性分析2012-01/2015-03在我院眼科行白内障超声乳化联合人工晶状体植入术、白内障囊外摘除联合人工晶状体植入术、青光眼小梁切除术1356眼,对发生角膜后弹力层脱离的29眼患者的治疗及预后进行观察。
　　结果：发生角膜后弹力层脱离的29眼患者经过相应治疗,未发生角膜内皮失代偿。视力恢复达4.1~4.8,角膜水肿消失,基本恢复透明,UBM检查证实后弹力层复帖。
　　结论：角膜后弹力层的解剖特性、内眼手术中切口的方式、手术器械的损伤以及患者角膜可能存在的病理改变,是造成角膜后弹力层脱离的主要原因。内眼手术中及术后及时发现角膜后弹力层脱离,并采取积极有效的综合治疗对角膜后弹力层脱离患者的视力恢复有着重要的意义。

Clinical analysis of descemet membrane detachment after intraocular surgery

AIM:To investigate the causes and therapys of descemet membrane detachment in the patients received phacoemulsification with intraocular lens(IOL)implantation, extracapsular cataract extraction with IOL implantation and trabeculectomy respectively.

METHOD:A retrospective analysis was applied for 1 356 eyes which had received one of above-mentioned surgeries from January 2012 to March 2015. Total 29 eyes with descemet membrane detachment were noted.

RESULTS:After the appropriate treatment, no corneal endothelial decompensation happened in the 29 eyes, and the visual acuity recovered to 4.1-4.8.

CONCLUSION:The main reasons for descemet membrane detachment are the anatomical features of descemet membrane, the incision adopted in the intraocular surgeries, the injuries caused by the surgical instruments and the potential pathological changes in the patients'' cornea.Timely detection of descemet membrane detachment during and post-operation and adoption of proper treatment is important for the restoring of the visual acuity.