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目的阐明乳化硅油进入前房后可能对角膜内皮产生直接毒性和机械阻挡作用,继而诱发角膜内皮失代偿。方法报道1例白内障超声乳化术后乳化硅油进入前房致角膜内皮失代偿的病例,结合既往文献对硅油相关角膜病变的发病机制、发病时间和影像学检查进行探讨。结果 1例27岁男性行白内障超声乳化术后乳化硅油进入前房,致使角膜内皮细胞数量显著下降,丢失率高达42.5%;角膜内皮镜下显示内皮六边形细胞数量下降,平均细胞面积增加,继而发生角膜内皮失代偿。结论对于不易取尽硅油同时合并晶体不全脱位病例需警惕眼内残留乳化硅油进入前房诱发的角膜内皮损害。
Objective To clarify the emulsified silicone oil into the anterior chamber may have direct toxicity and mechanical barrier to the corneal endothelium, and then induce corneal endothelial decompensation. Methods A case of corneal endothelium decompensation induced by emulsified silicone oil in phacoemulsification cataract surgery was reviewed. The pathogenesis, onset time and imaging examination of silicone oil-associated corneal lesions were discussed in combination with previous literatures. Results A 27-year-old male underwent phacoemulsification and phacoemulsification into the anterior chamber, resulting in a significant decrease in corneal endothelial cells with a loss rate as high as 42.5%. Corneal endoscopic examination showed that the number of endothelial hexagonal cells decreased and the average cell area increased. Corneal endothelial ensuing decompensation. CONCLUSIONS: In the case of difficult to remove silicone oil combined with dislocation of the lens, vigilant residual intraocular emulsion of silicone oil into the anterior chamber induced corneal endothelial damage.