前房人工水晶體併發之偽晶症水疱性角膜病變

Pseudophakic Bullous Keratopathy-Complication of Anterior Chamber Intraocular Lens Pseudophakic Bullous Keratopathy

吳志翹(Chih-Chiau Wu) ； 盧雪玉(Hsuei-Yuh LU) ； 陳昌文(Chang-Wen Chen) ； 許淑娟(Shwn-Jiuan Shen)

《中華民國眼科醫學會會刊》 30卷2期 (1991/12) Pp. 16-20

https://doi.org/10.30048/ACTASOS.199112.0045

摘要

台北榮總收集87位病人（90眼）因置放前房人工水晶體而併發偽晶症水疱性角膜病變的病人，平均年齡為68歲。依植入的前房人工水晶體型式來分類，82眼為ORC廠牌的Stable-flex，6眼為Leiske型，2眼為虹膜因定型；平均發病時間為3.5年。
至研究期限為止，54眼(60%)已接受角膜移植手術；其中，77.8師移植的角膜仍完好；22.2%則已失敗，接受第二次手術；有80%的病人手術復視力改進，視力無法進步的原因大部份為黃斑部水腫或青光眼。
在10%病人中發現角膜已產生新生血管，在電子顯微鏡檢查巨噬細胞可在新生血管的附近發現，這或許是臨床上對於巨噬細胞刺激新生血管產生的一個證明。
在我們的研究中，在所有植入前房人工水晶體的患者中，大約已有18.6%罹患偽晶症水疱性角膜病變，而且，植入前房人工水晶體已達5年以上者，罹患率高達40.7%。

並列摘要

87 patients (90 eyes) suffering from Pseudophakic bullous Keratopathy were collected at Taipei Veteraus General Hospital. Average age of study group was 68 years old. The style of anterior chamber lens including 82 eyes stable- flex, 6 eyes Leiske, 2 eyes Medallion iris fixating lens have been inserted.
The average time between intraocular lens implatation and developement of Pseudophakic bullous Keratopathy is 3.5 years. 54 eyes (60%) have recieved penetrating keratoplasty. The operation is suscessful in 77.8%, 22.2% has failed and have recieved second time operation. Vision is improved in 80% of cases. The resons for poor visual result are due to cystoid macular edema and glaucoma.
Neovascularization of cornea was found in 10% of the study group. Under electronmicroscopic examination, macrophage was found near by the neovascularization. This may be a clinical evidence for macrophage related with neovascularization.
In our survay, about 18.6% of patients implanted with anterior chamber lens have developed Pseudophakic bullous Keratopathy. The patients receiving anterior chamber lens insertion for more than 5 years have the risk of 40.7% in developing Pseudophakic bullous Keratopathy.

並列關鍵字

Pseudophakic bullous Keratopathy ； Anterior chamber intraocular lens