超高度近视眼角膜的共聚焦显微镜观察  

Observation of the cornea of ultra-high myopic eyes with confocal microscope

作　　者：赵金荣[1] 赵少贞[2] 袁佳琴[2] 

机构地区：[1]天津人民医院,300121 [2]天津医科大学眼科医院,300384

出　　处：《中华眼视光学与视觉科学杂志》2013年第9期561-563,共3页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的利用共聚焦显微镜观察超高度近视眼角膜的超微结构改变。方法前瞻性病例对照研究。选择拟行准分子激光原位角膜磨镶术（LASIK）的超高度近视患者54例（54眼）作为超高度近视组，屈光度-10．00～17．00D，平均（-13．27±3．24）D；同时选择中低度近视患者65例（65眼），屈光度-1．00—6．00D，平均（-3．12±2．32）D作为对照组。于术前行共聚焦显微镜检查角膜上皮、前弹力层、前后基质、内皮细胞及角膜厚度。采用独立样本t检验对数据进行分析。结果在共聚焦显微镜下超高度近视组6眼（11％）可以看到角膜前弹力层及后基质少量中等反光的点状沉积物，5眼（9％）可见异常基质内神经。角膜前基质细胞、后基质细胞、内皮细胞数及角膜厚度均较中低度近视组低．内皮细胞六角形细胞百分比较中低度近视组低，内皮细胞面积变异系数较中低度近视组高．差异有统计学意义（t=6．41、5．25、2．39、2．67、3．90、4．62，P〈0．05），上皮下神经丛神经纤维与中低度近视组相比，差异无统计学意义（t=0．88，P〉0．05）。结论超高度近视眼角膜与中低度近视眼相比．在超微结构上角膜细胞数减少，内皮细胞形态大小亦有不同，对于角膜功能的影响尚不清楚。Objective To investigate the ultrastructural changes in the super-high myopia cornea. Methods It is a perspective case-control study. Fifty-five ultra-high myopia eyes with diopter range from -10.00 D to-17.00 D, average -13.27±3.24 D and 65 low and moderate myopia eyes with diopter range from -1.00 D to-6.00 D, average -3.12±2.32 D were included in this study. All the patient were axamined with confocal microscope including the cornea epithelium, Bowman＇ layer, anterior stroma, posterior stroma, endothelium and the patchmetry the results were analyzed by using independent sample t-test methods. Results In ultra-high myopia group 6 eyes （11%） can been observed the deposits at basal cells layer and posterior stroma, and 5 eyes （9.%） can been observed abnormal nerve fiber at posterior stroma.The cell count in anterior stroma, posterior stroma and endothelium is less than that of low and moderate myopia, and the differences were statistically significant （t=6.41, 5.25, 2.39, P〈0.05）. Pleomagthism of endothelium increased and polymagthism decreased and the corneal patchmetry of ultrahigh myopia is more thinner, the difference is statistically significant （t=2.67, 3.90, 4.62, P〈0.05）. The subepithelial plexus nerve fibers difference is not statistically significant （t=0.88, P〉0.05）. Conclusion Ultra-high myopia cornea have some difference in ultrastructure compared with low and moderate myopia, whether that corneal function would be involved is not clear.

关 键 词：角膜 近视 退行性 显微镜检查 共焦 

分 类 号：R778.11[医药卫生—眼科]