共焦显微镜检查在小梁切除术后干眼诊疗中的应用  

Application of confocal microscopy in the diagnosis and treatment of dry eye after trabeculectomy

作　　者：董晓云[1] 王瑞夫[1] 高晓唯[1] 李文静[1] 雷代坤[1] 

机构地区：[1]中国人民解放军第四七四医院全军眼科中心

出　　处：《国际眼科杂志》2011年第9期1668-1669,共2页International Eye Science

摘　　要：目的:探讨共焦显微镜检查在小梁切除术后干眼诊疗中的应用价值。方法:对行小梁切除术的青光眼患者42例58眼,术前1d;术后1wk;1,3mo进行活体共焦显微镜(confocalmicroscopy,CM)检查,观察角膜组织的形态学改变,结合泪膜破裂时间(breaking-up time,BUT)、基础泪液分泌试验(SchirmerⅠtest,SⅠt)分析小梁切除术后眼表结构的变化。结果:与术前相比,术后1d;1wk术眼角膜上皮细胞密度下降,大小不均,高反光细胞增多。SⅠt程度明显增加,BUT缩短,差异有统计学意义(P<0.05),术后1,3mo时CM检查显示角膜上皮细胞形态、密度、SⅠt及BUT程度恢复至术前水平,与术前比较差异无统计学意义(P>0.05)。结论:通过CM检查可在细胞水平上评价小梁切除术对眼表结构的影响,对术后早期干眼的诊断和治疗有重要的临床指导价值。AIM：To investigate the application of confocal microscopy in the diagnosis and treatment of dry eye after trabeculectomy.METHODS：In vivo confocal microscopy（CM） examination was conducted in 42 glaucoma patients（58 eyes） 1 day before and 1 week,1 month,3 months after trabeculectomy to observe the morphology changes of corneal tissue,and combining breaking-up time（BUT）,Schirmer Ⅰ test（SⅠt） to analyse ocular surface changes in the structure after trabeculectomy.RESULTS：Compared with the preoperative,postoperative 1 day,1 week corneal epithelial cell density of operated eye decreased,with disparity of the size and increased high reflective cells.SⅠt was significantly increased,BUT shortened,the difference was statistically significant（P0.05）.1 month,3 months after surgery,CM examination showed corneal epithelial cell morphology,density,SⅠt and BUT recovered to preoperative levels.Compared with the preoperative,the difference was not statistically significant（P0.05）.CONCLUSION：By confocal microscopy,trabeculectomy＇s influence on ocular surface structure can be evaluated at the cellular level,which has important clinical value on the early postoperative diagnosis and treatment of dry eye.

关 键 词：共焦显微镜 小梁切除术 干眼 

分 类 号：R779.6[医药卫生—眼科]