【摘要】 目的:观察先天性无虹膜家系并发白内障患者的晶状体前囊膜的病理学变化,探讨晶状体前囊膜变薄,变脆的病理学机制及对手术方案的意义。方法:收集家族性先天性无虹膜并发白内障患者术中的晶状体前囊膜或晶状体,分别进行光镜和电镜检查。结果:家族性先天性无虹膜合并白内障患者的晶状体前囊膜明显脆弱、变薄。光镜和电镜见晶状体上皮细胞呈变性、坏死、脱失,致使上皮细胞层不连续;有的病例晶状体上皮细胞局灶性增生、复层化;前囊膜表层板层结构均变薄甚至消失。结论:晶状体上皮细胞的退行性和增殖性改变可能是导致先天性无虹膜合并白内障患者的晶状体前囊膜变薄、囊膜的脆弱性增加的原因。提高对前囊膜脆弱性的认识,有助于减少术中囊膜的并发症,达到安全的手术结果。更多还原

【Abstract】 Objective: To observe the pathological changes of the lens and anterior lens capsule of the patients with familial congenital aniridia, and discuss the histopathological etiology of the fragility of the anterior capsule and the significance of surgical project. Methods: Anterior lens capsules and lens specimens were obtained from aniridic patients during cataract surgery. The intraoperative behavior of each capsule was noted, after which the specimens were submitted for histopathologic evaluation and electron microscope examination. Results: The anterior lens capsule was extremely fragile and remarkably thin. Degenerative changes(degeneration, necrosis, loss) of the lens epithelium and discontinuity of the lens epithelium were found in some specimens. Proliferation and double layer of the epithelial cells in some area of the specimens can be seen also. Ply structure of the anterior capsule became thin or disappeared. Conclusion: Degenerative or proliferative changes of the lens epithelial cells were associated with the thinness and extreme intraperative fragility of the anterior lens capsules in familial aniridia with cataract. Greater awareness of anterior capsule fragility in some aniridic patients with cataract may reduce the risk of capsule complications and lead to safer surgical outcomes.更多还原