准分子激光手术对角膜内皮细胞影响的观察  

Observation on the influence of excimer laser surgery on corneal endothelial cells

作　　者：刘敏[1] 赵骏[1] 

机构地区：[1]沧州眼科医院功能科,河北061001

出　　处：《中华眼外伤职业眼病杂志》2016年第10期734-738,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察准分子激光手术对角膜内皮细胞的影响。方法在我院行准分子激光手术的近视217例（434只眼），依据术前角膜厚度和近视屈光度而采取不同的手术方法，分为三个组。分别是准分子激光原位角膜磨镶术（LASIK组），148只眼；前弹力层下准分子激光角膜磨镶术（SBK组），146只眼及上皮瓣下准分子激光原位角膜磨镶术（Epi-LASIK组），140只眼。观察术前及术后1周、1个月、3个月和1年以共焦显微镜观察角膜中央区内皮细胞的形态，并对其密度、平均面积及边数、变异系数和六角形细胞百分比等进行分析。结果LASIK组和Epi—LASIK组术后1周可见角膜中央少部分内皮细胞水肿，六边形形态不规则；三个组术后1周及1个月六角形细胞百分比均较术前降低，差异有统计学意义（P〈0．05），但术后1年角膜内皮细胞密度、平均面积及边数、细胞面积变异系数与术前分别两两比较差异均无统计学意义（P〉0．05）。结论准分子激光矫正近视的不同手术方式均不造成角膜中央内皮细胞密度的降低，但术后短时间内六角形细胞百分比一度降低，临床上应引起注意。Objective To observe the influence of excimer laser surgery on corneal endothelial cells. Methods A total of 434 eyes of 217 persons, who underwent excimer laser surgery in our hospital were collected. Depending on the corneal thickness and degree of myopia, all the cases were divided into 3 groups. They were laser in situ keratomileusis （LASIK）, 148 eyes; sub-bowman keratomileusis（ SBK）, 146 eyes; and epipolis laser in situ keratomileusis （Epi-LASIK） , 140 eyes. The shape and density, average area and number of side, variation coefficient and percentage of heragonal corneal endothelial cells of the central region were observed before the operation and 1 week, 1 month,3 months and 1 year after operation. Results One week after surgery, small part of the central corneal endothelial cells was edematous and irregular hexagonal cells in LASIK and Epi-LASIK group. One week and 1 month postoperatively, the percentage of hexagonal cells in three groups decreased contrasted with that of preoperative and the differences were statistically significant （P 〈 0.05 ）. The density, the average area and number of side, variation coefficient compared with preoperative one had no statistically significant difference （ P 〉 0.05 ）. Conclusion Excimer laser surgery for the correction of myopia does not result in lower cell density of central corneal endothelium, but the percentage of hexagonal cells decreases in a short time after the operation, which needs attention in clinic.

关 键 词：显微镜检查 共焦 手术 激光 准分子 内皮细胞 角膜 

分 类 号：R779.63[医药卫生—眼科]