Short-Term Observation Of Protective Effect Of Lens On Corneal Endothelium In Vitrectomy

Objective: To observe morphological changes and parameter changes in short-term of corneal endothelium in different vitreoretinal surgeries,so as to investigate the preventive effect of lens on corneal endothelium during different vitreoretinal surgeries.Methods: 32 patients(32eyes)undergone vitreoretinal surgery +silicone tamponade and 1enticular vitreoretinal surgery+silicone tamponade.Took pictures of corneal endothelium with Topcon SP-3000 non-contact specular microscopy before operation and within two weeks after operation,directly observe morphological changes of the corneal endothelium,and measured the corneal endothelium cell density (CD), average cell area (AVE), coefficient of variation of average area (CV),and ratio of hexagonal cells (RHC) with IMAGEnet system.And analyzed the corneal endothelium parameters of the two groups by statistics. all the data were analyzed by Statistical Package for the Social Sciences (SPSS).Results: There were some kinds of abnormal morphology of corneal endothelium after vitrectomy:changes in cell size uniformity of corneal endothelium, changes in cell morphology consistent of corneal endothelium, blur intercellular space of corneal endothelium,black areas of corneal endothelium and Other abnormal structures.The above changes is more obviously in the postoperative aphakia.Comparing the corneal endothelium parameters between before and after operation,we found after vitreoretinal surgery and silicone tamponade,the corneal endothelial cell densities and ratio of hexagonal cells were decreased, average cell area and coefficient of variation of average area were increased, there was no statistically significant differences compared with before operation (P>0.05).After 1enticular vitreoretinal surgery and silicone tamponade,the corneal endothelial cell densities and ratio of hexagonal cells were decreased significantly, average cell area and coefficient of variation of average area were increased significantly, there was statistically significant differences compared with before operation (P<0.05).Conclusion:1. In vitrectomy, Lens play an important role in the protection on the corneal endothelial cells through the barrier function of variety damage factors.Retention of the lens can minimize the damage of various factors on corneal endothelial cells.2. The qualitative and quantitative analysis of corneal endothelium by the examination of non-contact specular microscopy with IMAGEnet system was significant in clinical application of the safety of operation and preoperative evaluation of complications of vitrectomy. It should be as routine examination.3. To reduce the damage of corneal endothelial cells and observation of complications, doctors should pay more attention to check endothelial cells and have it protectived during vitrectomy.4. When preoperative examination revealed patients with poor function of corneal endothelial cell, we should try to keep the lens in vitrectomy.