| BackgroundSilicone oil has special physical and chemical characteris-tics, which can support the retina for long time. After being widely used in the clinics, it has greatly improved the success rate of complicated retina detachments such as proliferative diabetic retinopathy, proliferative vitreo-retinopathy, giant retinal tears, traumatic retinal detachment and acute retina necrosis with retina detachment.Nevertheless, as time goes by the complications of silicone oil injection have become more and more exposed. Corneal opacification (include band keratopathy, corneal edema and cornealabrasions.) is one of the important complications. There is debates on the safety of such surgery on aphakic eyes. Some studies.show that the probability of corneal complication will increase in aphakic eyes. The main reason is that there is no barrier to prevent the emulsified or unemulsified oil drops from contacting the corneal endothelium, which stops the transport of cornea nutritions , reduces the density of corneal endothelium cells, increases the thickness of the cornea. However, Karrel considered that silicone oil was a kind of inert substance. It might not influence the corneal endothelium if they are not contact. To learn the influence of lens to the stability of corenal endothelium function is important- for clinic doctors to chose the way of surgery.1. ObjectiveThe study use corneal endothelium density(CED) and corneal thickness to illustrate the function and shape of corneal endothelium cells. Set aphakic and phakic two groups. Observed at preoperation and post operation. Compared each parameter to learn the safety of silicone oil to both groups, and it's diference. sothat to provide dependence to the clinics.2.Subjects and Methods2.1 Subjects45 eyes of 45 patients who undergo vitrectomy with silicone oil injection in the second hospital eye center from September 1999 through September 2000 were devided into two groupsiphakic eyes (22eyes), aphakic eyes (23eyes). Mean age is 50. 09 ?11. 87years old.. 46. 87 ?4. 92years old0All surgeries were done by the same doctor . all patients were examined by author. Eye tentions were well controled before or after surgery.2. 2 method2. 2. 1 Standard par plana vitrectomy with BSS liquid, cut the vitreous base as clean as possible.2.2.2 Stripping preretinal membrane, unchain the traction, cut the retina when necessary, relief the proliferation under the retina.2. 2. 3 Inferior iridectomy at 6: 00 in aphakic eyes to prevent silicone oil from going to anterior chamber.2. 2.4 Perfluorcarbon injection to smooth retina, looking for the hole , then photocoagulation and cryopexy to close it.2. 2. 5 Oil/fluid exchange , or gas /fluid then oil/gas exchange. Fill silicone oil (ADATO SIL-OL 5000)into the vitreous cavity.2. 2. 6 Some patients underwent scleral buckling surgery.2. 3 Postoperation TreatmentDXM 5mg, cephazoline or tobramycine for iv. Steroid and antibiotic drops were used daily. Diamox were used occasionally to control eye tention. Pupil of phakic eyes were dilated after 'surgery.2. 4 Outcome Measures2. 4. 1 All patients were examined carefully before surgery. And their information were written down include history of the disease, diagnosis, reflected vision acuity, eye tension, corneal thickness, and corneal endothelium density.2. 4.2 The operative procedurs were written down according to the operative reports.2.4.3 Post operative data were collected at 1,3,6,9 month, include reflected vision acuity, slit lamp examing, fundusexamine , corneal thickness, and corneal endothelium density.2. 4.4 The endothelium cells of the center of the cornea were observed and measured with KONAN NONCON ROBO specular microscope made in Japan. Each picture was counted for three times to get the average of endothelium cell dencities.2.4.5 Corneal thickness was measured with NIDEK UP-1000 corneal pachymeter made in Japan, after topic anesthesia, the thickness of superior, center and infer...
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