激光扫描共焦显微镜观察穿透角膜移植术后角膜的形态学特征  

Laser scanning confocal microscope in transplanted human corneas

作　　者：韩玉萍[1] 李冰[1] 赵炬伟[1] 张明花[1] 

机构地区：[1]山西省眼科医院,太原 030002

出　　处：《中国实用眼科杂志》2007年第3期306-308,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的研究活体穿透角膜移植术后各层角膜组织的激光扫描共焦显微镜（Laser Scan-ning Confocal Microscope,LSCM）的形态学特征。方法应用海德堡视网膜激光断层扫描仪Ⅱ/Rostock角膜模块（HRTⅡ）对20例20眼穿透角膜移植术后40天～2年的患者进行检查,记录并分析其各层角膜图像。结果穿透角膜移植术后早期角膜上皮细胞排列欠规则;Bowman膜和Descemet膜在激光共焦显微镜下无细胞结构;所有患者浅基质层细胞均较深基质层密集;稳定角膜植片其内皮细胞排列紧密,形态为均一六边形结构;所有患者均未发现上皮下神经丛及基质神经;术后植片排斥者有其特殊形态学表现。结论激光扫描共焦显微镜可活体检查穿透角膜移植术后角膜各层组织结构和细胞的病理改变,为临床诊断及用药提供有价值的客观依据,并在跟踪随访方面具有重大意义。Objective To study the morphological changes of the human corneas in vivo after penetrating keratoplasty by Laser Scanning Confocal Microscope （LSCM）. Methods 20 eyes of 20 patients on 40 days-2 years after penetrating keratoplasty （pkp） were examined by Heidelberg Retina Tomograph H Rostock Cornea Module （HRT Ⅱ） in vivo .Images were recorded by continuously focusing the optical section through the full thickness of cornea. Results The cells of epithelium were irregular in the early stage after penetrating keratoplasty. Bowman＇s membrane and descemet＇s membrane had no visible cells in LSCM. The cell density of anterior stroma was higher than that of posterior stroma in all patients. The endothelium cells of stable grafts showed 6-edge shape and arranged closely. Nerves could not be seen in all transplanted corneas. The rejected grafts had its special characters in LSCM. Conclusions LSCM is a new tool for the study of cellular morphology and construction of human corneas after PKP in vivo. It can provide valuable objective basis for the clinical diagnosis, medical administration, and follow-up after operation.

关 键 词：激光扫描共焦显微镜 穿透角膜移植 角膜 形态学 

分 类 号：R735.7[医药卫生—肿瘤]