放射状角膜切开术后远期角膜内皮细胞的改变  

Long-term changes of corneal endothelial cells with radial keratotomy

作　　者：赵露[1] 王艳玲[1] 刘萍[1] 刘碹[1] 

机构地区：[1]首都医科大学附属北京友谊医院眼科,100050

出　　处：《中华眼科杂志》2008年第6期511-516,共6页Chinese Journal of Ophthalmology

摘　　要：目的探讨放射状角膜切开术（RK）后远期角膜内皮细胞的损失与变异情况。方法为病例对照研究。选择1989年1月至1996年12月在首都医科大学附属北京友谊医院眼科行RK并可随访到的51例（101只眼）患者，作为RK组。2006年11月至2007年3月在同院眼科门诊就诊的无其他眼疾的51例（102只眼）近视眼志愿者作为正常对照组。两组患者均由同一检查者使用Topcon SP2000型非接触型角膜内皮显微镜对角膜内皮细胞进行观察，记录中央、上方、下方、颞侧及鼻侧5个方位角膜内皮细胞密度（CD）、细胞平均面积（AVG）、变异系数（CV）及六边形细胞百分比（H％）。对计量资料进行数据的正态性检验与方差齐性检验。RK组与对照组的各年龄段患眼的数据采用两个独立样本t检验。RK组内数据的比较采用单因素方差分析方法。结果各年龄段中央、上方、下方、颞侧及鼻侧5个方位，RK组与对照组间CD、AVG、H％的比较差异无统计学意义（P〉0．05）。两组间CV的比较差异有统计学意义，两组间30岁～的年龄段中央区比较t=3．742、P=0．000，上方t=3．627、P=0．000，下方t=3．180、P=0．002，鼻侧t=2．448、P=0．016，颞侧t=3．149、P=0．002；两组间40岁～的年龄段中央区比较t=4．446、P=0．000，上方t=2．444、P=0．017，下方t=2．113、P=0．038，鼻侧t=3．214、P=0．002，颞侧t=2．680、P=0．009；两组间50岁～的年龄段中央区比较t=2．360、P=0．024，上方t=2．600、P=0．013，下方t=2．787、P=0．008，鼻侧t=2．144、P=0．038，颞侧t=2．177、P=0．036。但是，RK术后CV与术后时间无相关性（P〉0．05）；不同切口数量组间中央、上方、下方、颞侧及鼻侧相应方位CD、AVG、CV、H％的比较差异均无统计学意义（P〉0．05）。RK术后远期角膜内皮细胞形态发生了细微的变化，角膜内皮细胞的面积CV增大。结论RK术后患者行其�Objective To investigate the long-term loss and variation of corneal endothelial cells after radial keratotomy. Methods By the way of ease-control study, 51 myopia （ 101 eyes） patients who underwent RK in Beijing Friendship hospital, from January 1989 to December 1996 is the RK group. 51 myopia （102 eyes） outpatients who have no other eye diseases is the control group. The volunteers are the outpatients of Department of Ophthalmology in Beijing Friendship Hospital from November 2006 to March 2007. Corneal endothelial cells are examined by Topeon SP2000 non-contact corneal endothelial microscope. To survey corneal endothelium of center, superior, inferior, temple side and nasal side, to study endothelial cell density, average areas, coefficient of cell variation in size and hexagonality. Results The differences of endothelial cell density, average areas, hexagonality are no significant between the RK group and the control group with the same age stage（P 〉0. 05）. The differences of coefficient of cell variation are significant. In the 30 year old stage, the result of center is t= 3.742, P = 0. 000, the result of superior is t = 3. 627,P = 0. 000, the result of inferior is t = 3. 180, P = 0. 002, the result of nasal side is t = 2. 448, P = 0. 016, the result of temple side is t =3. 149,P =0. 002. In the 40 year old stage, the result of center is t =4. 446,P = 0. 000, the result of superior is t = 2. 444, P = 0. 017, the result of inferior is t = 2. 113, P = 0. 038, the result of nasal side is t = 3.214,P = 0. 002, the result of temple side is t = 2. 680,P = 0. 009. In the 50 year old stage, the result of center is t = 2. 360,P = 0. 024, the result of superior is t = 2. 600,P = 0. 013, the result of inferior is t = 2. 787, P = 0. 008, the result of nasal side is t = 2. 144, P = 0. 038, the result of temple side is t = 2. 177,P =0. 036. But the differences of coefficient of cell variation have no relationship with the time of RK（ P 〉 0. 05 ）. The differences of endothelial cell density, average are

关 键 词：角膜切开术 放射状 角膜内皮 细胞大小 细胞计数 

分 类 号：R686[医药卫生—骨科学]