板层角膜移植术后全层角膜组织改变的共焦显微镜观察  

The changes in each layer of corneal tissue after lamellar keratoplasty by confocal microscope in vivo

作　　者：黎明[1] 林跃生[2] 姚晓明[1] 宋书华[2] 陈家祺[2] 陈龙山[2] 

机构地区：[1]暨南大学附属深圳眼科医院,深圳518000 [2]中山大学中山眼科中心

出　　处：《中国实用眼科杂志》2005年第4期352-355,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的　研究活体板层角膜移植术后角膜各层组织的共焦显微镜(confocalmicroscopy)形态学改变。方法　应用Confoscan 2.0共焦显微镜对板层角膜移植术后3月～3年,角膜植片稳定的患者共17例17眼,进行扫描检查,记录与分析各层角膜图像。结果　共焦显微镜上能够清楚地观察到稳定角膜的上皮细胞、基底层细胞、前弹力层,它们同正常角膜的相应细胞在图像上没有显著差别。但植片与植床的基质细胞在共焦显微镜图像上有着明显的差异。板层角膜移植术后稳定角膜植片的基质细胞,细胞核较小呈中等反光,排列较植床的基质细胞紊乱。而角膜植床的基质细胞,细胞核较大也呈中等反光,排列较植片的基质细胞稍整齐。结论　1、Confoscan 2 0共焦显微镜可活体检查板层角膜移植术后角膜组织结构和细胞的病理改变。2、板层角膜移植术后可成功的重建眼表。3、活体板层角膜移植术后稳定角膜上有自体角膜基质细胞与异体的角膜基质细胞同时共存,角膜内皮细胞的形态结构正常。4。Objective The stable aim corneas of the lamellar keratoplasty were in-real time observation and morphological evaluation by confocal 2.0 microscopy.Methods Seventeen eyes of 17 patients on 3 months～3 years after lamellar keratoplasty(LKP)were examined by confocal 2.0 microscopy in vivo.Images were recorded by continuously focusing the optical section through the full thickness central cornea.Results The epithelium,basal epithelial layer,lamina elastic anterior were observed obviously,the same as the normal corneas of the confocal microscope.The keratocytes between the honor and the donor were different on the images of the confocal microscope.The keratocytes nuclei of the stable donor corneas were smaller,more disorder than that of honor.Conclusions 1.Confocal scanning microscopy is a new tool for the study of cellular morphology and construction of the lamellar keratoplasty corneas.2.LKP can reconstruct the eye surface successfully.3.The keratocytes of donor and honor corneas were coexistence and differentiated on the confocal microscope.The endothelium is normal.4.The visual acuity is not good after LKP may be caused by the roughness between the corneal buttons and derangement of dornor keratocytes.

关 键 词：移植术后 微镜观察 组织改变 共焦显微镜 角膜基质细胞 全层 板层角膜移植 角膜植片 形态学改变 基底层细胞 方法应用 扫描检查 上皮细胞 正常角膜 活体检查 病理改变 组织结构 重建眼表 形态结构 术后视力 结构紊乱 角膜板层 

分 类 号：R656.6[医药卫生—外科学] R282.71[医药卫生—临床医学]