[1]向小红,周琦,田敏,等.微创玻璃体切割术后角膜上皮细胞功能障碍的临床分析[J].眼科新进展,2018,38(12):1172-1175.[doi:10.13389/j.cnki.rao.2018.0277]
　XIANG Xiao-Hong,ZHOU Qi,TIAN Min,et al.Clinical analysis of corneal epithelial cell dysfunction after minimally invasive vitrectomy[J].Recent Advances in Ophthalmology,2018,38(12):1172-1175.[doi:10.13389/j.cnki.rao.2018.0277]
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
38卷
期数:
2018年12期
页码:
1172-1175
栏目:
应用研究
出版日期:
2018-12-05

文章信息/Info

Title:
Clinical analysis of corneal epithelial cell dysfunction after minimally invasive vitrectomy
作者:
向小红; 周琦; 田敏; 唐敏; 曹阳; 吕红彬
646000　四川省泸州市，西南医科大学第一附属医院眼科
Author(s):
XIANG Xiao-Hong; ZHOU Qi; TIAN Min; TANG Min; CAO Yang; LV Hong-Bin
Department of Ophthalmology，the First Affiliated Hospital of Southwest Medical University，Luzhou 646000，Sichuan Province，China
关键词:
微创玻璃体切割术; 角膜上皮细胞功能障碍; 临床分析
Keywords:
minimally invasive vitrectomy; corneal endothelium dysfunction; clinical analysis
分类号:
R779.6
DOI:
10.13389/j.cnki.rao.2018.0277
文献标志码:
A
摘要:
目的　探讨25G微创玻璃体切割术后患者发生角膜上皮细胞功能障碍（corneal epithelial dysfunction，CED）的相关因素及其治疗疗效。方法　将2015年12月至2017年1月在我院行25G微创玻璃体切割术患者231例（231眼）纳入本研究，收集所有患者的一般情况、眼部和全身合并症、手术方式、术中玻璃体内填充物及术后用药，分析CED发病的危险因素，并对术后发生CED患者治疗前后最佳矫正视力（best corrected visual acuity，BCVA）、发病时间、治疗方案、恢复时间及疗效等进行分析。结果　231例231眼行25G微创玻璃体切割术患者术后发生CED 23眼，发生率为9.96%。患者年龄、性别、手术原因与术后发生CED均无相关性（均为P>0.05）；白内障联合玻璃体切割术、术中填充硅油、患者自身合并糖尿病及睑板腺功能障碍以及术后联合应用抗青光眼药物均是术后发生CED的危险因素（均为P<0.05）。23例23眼CED患者发病时间为（26.82±13.08）d，经治疗恢复时间为（21.65±12.32）d；治疗后CED患者BCVA为（2.04±0.74）LogMAR，较治疗前BCVA［（1.85±0.75）LogMAR］提高，差异有统计学意义（P<0.05）。结论　白内障联合玻璃体切割手术、硅油填充、合并糖尿病、睑板腺功能障碍及局部药物毒性可能增加微创玻璃体切割术后CED的发生；CED患者经药物或联合角膜绷带镜或自体血清治疗可取得良好效果。
Abstract:
Objective　To explore the relative factors and treatment effects of corneal epithelial cell dysfunction （CED） after 25G+minimally invasive vitrectomy.Methods　Total 231 patients （231 eyes） was involved in this study，who underwent 25G+ minimally invasive vitrectomy treatment in our hospital，from December 5，2015 to February 6，2017.Collection the clinical datas of subjects was conducted，such as general situation，with diabetes or not，the complications of the eye，surgical approach，the filler in the vitreous cavity，and the postoperative medication，and eyelid gland images.The information the of the patients，who complicated with CED，such as onset time of CED，treatment plan，recovery time，BCVA and curative effect before and after treatment were collected.Results　The incidence of CED of 231 eyes was 9.96% （23 eyes） after 25G+ minimally invasive vitrectomy.Patients’ age，sex，and surgical causes have no related with CED （all P>0.05）.Cataract combined with vitrectomy，silicone oil filling，complicated with diabetes and eyelid dysfunction，and postoperative combination of anti-glaucoma drugs are risk factors of postoperative CED （all P<0.05）.Onset time of CED were （26.82±13.08）days，and average recovery time was （21.65±12.32）days through treatment.LogMAR BCVA was enhanced after treatment，from （2.04±0.74）LogMAR to （1.85±0.75）LogMAR，and there was significant change （P<0.05）.Conclusion　The related factors of CED after operation includes diabetes，meibomian gland dysfunction，and cataract surgery combined with vitrectomy，drugs toxicity，silicone oil filling and so on.Exceptive results can be achieved treatment by drugs and corneal bandage mirror as well as autologous serumt.

参考文献/References:

［1］　SUN C G，WANG S.Pay attention to the corneal epithelial cell dysfunction after cataract surgery［J］.Chin J Ophthalmol，2015，51（3）：161-162.
孙旭光，王森.重视白内障术后角膜上皮细胞功能障碍［J］.中华眼科杂志，2015，51（3）：161-162.
［2］　LOHMANN A M，VAN BEST J A，DE KEIZER R J.Corneal metabolism and epithelial barrier function after cataract surgery and intraocular lens implantation：a fluorophotometric study［J］.Int Ophthalmol，1995，19（4）：225-233.
［3］　MA C X，CHEN G，YUAN C F，TAN F L，LI B B.Clinical observation of the corneal epithelial cell dysfunction following cataract surgery［J］.Chin J Ocul Traum Occupat Eye Dis，2016，38（11）：831-833.
马成霞，陈刚，袁超峰，谭凤玲，李彬彬.白内障术后角膜上皮细胞功能障碍的临床观察［J］.中华眼外伤职业眼病杂志，2016，38（11）：831-833.
［4］　GONZALEZ ANDRADES M，ALONSO PASTOR L，MAURIE J，CRUZAT A H，DOHLMAN C，ARGUESO P.Establishment of a novel in vitro model of stratified epithelial wound healing with barrier function［J］.Sci Rep，2016，6：19395.
［5］　QU JH，SUN X G.Research progress of corneal epithelial basal cells and basement membrane［J］.Chin J Ophthalmol，2016，52（9）：703-707.
曲景灏，孙旭光.角膜上皮层基底细胞及其基底膜的研究进展［J］.中华眼科杂志，2016，52（9）：703-707.　
［6］　DIDENKO T N，SMOLIALOYA G P，SOROKIN E L，EGOROV V V.Clinical and pathogenetic features of neurotrophic corneal disorders in diabetes［J］.Vestn Oftalmol，1999，115（6）：7-11.
［7］　STORR PAULSEN A，SINGH A，JEPPESEN H，NORREGAARD J C，THULESEN J.Corneal endothelial morphology and central thickness in patients with type II diabetes mellitus［J］.Acta Ophthalmol，2014，92（2）：158-160.
［8］　WANG Y C，LI S，CHEN X，MA B，HE H，LIU T，et al.Meibomian gland absence related dry eye in ectodysplasin a mutant mice［J］.Am J Pathol，2016，186（1）：32-42.
［9］　BOSCIA F，CARDASCIA N，SBORGIA L，FURINO C，FERRARI T M，SBORGIA C，et al.Evaluation of corneal damage by combined phacoemulsification and passive efflux of silicone oil in vitrectomized eyes［J］.J Cataract Refract Surg，2003，29（6）：1120-1126.
［10］　BARAC J，KATUSIC D，IVANCIC D，SISLJAGIC V，BRADVICA M.Effect of intraocular silicone oil on ocular tissue［J］.Coll Antropol，2005，29（Suppl 1）：51-54.
［11］　VINCENT S J，VINCENT R A，MANNING L M，LEE GA.Persistent anterior chamber silicone oil and myopia［J］.J Cataract Refract Surg，2015，41（7）：1527-1529.
［12］　LEE J S，KIM Y H，PARK Y M.The toxicity of nonsteroidal anti-inflammatory eye drops against human corneal epithelial cells in vitro［J］.J Korean Med Sci，2015，30（12）：1856-1864.
［13］　KADMIEL M，JANOSHAZI A，XU X，CIDLOWSKI J A.Glucocorticoid action in human corneal epithelial cells establishes roles for corticosteroids in wound healing and barrier function of the eye［J］.Exp Eye Res，2016，152（1）：10-33.
［14］　MATSUMOTO S，STERN M E.Effect of anti-infective ophthalmic solutions on corneal cells in vitro［J］.Adv Ther，2000，17（3）：148-151.
［15］　LI N，DENG X G.Animal models of dry eye［J］.Int Rev Ophthalmol，2010，34（5）：298-304.
李娜，邓新国.干眼动物模型的研究现状［J］.国际眼科纵览，2010，34（5）：298-304.
［16］　PINHEIRO R，PANFIL C，SCHRAGE N，DUTESCU RM.The impact of glaucoma medications on corneal wound healing［J］.J Glaucoma，2016，25（1）：122-127.
［17］　NAGAI N，YOSHIOKA C，TANINO T，SHIMOMURA Y.Decrease in corneal damage due to benzalkonium chloride by the addition of mannitol into timolol maleate eye drops［J］.J Oleo Sci，2015，64（7）：743-750.
［18］　SUN Y Z，GU F，SUN P，ZHANG H，LIU Z L.Discussion of treatment for persistent corneal epithelium defect after vitrectomy［J］.Int Eye Sci，2011，11（6）：1035-1037.

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更新日期/Last Update: 2018-12-04