角膜生物力学的临床应用  

Clinical application of corneal biomechanics

作　　者：李涛[1] 杜之渝[1] 晏丕松[1] 张玙[1] 高欢欢 陈竹[1] 

机构地区：[1]重庆医科大学附属第二医院眼科,400010

出　　处：《国际眼科纵览》2017年第6期409-413,共5页International Review of Ophthalmology

摘　　要：角膜具有弹性和黏性，其基质层间胶原纤维构成的生物力学特性，对于维持眼球固有形态及保护内层结构具有重要作用。圆锥角膜随着角膜基质变薄、Bowman膜破裂和角膜上皮基底膜铁质沉积，角膜生物力学特性呈现下降趋势；青光眼在长期高眼压状态下，维持角膜透明的泵功能和屏障作用受到明显影响，导致胶原纤维水肿，从而角膜抵抗外力的能力降低，随之生物力学特性降低；屈光手术主要针对角膜基质层进行切削，导致角膜厚度变薄以及胶原纤维形态遭到破坏，术后继发性圆锥角膜的风险高；白内障超声乳化手术中的机械性损伤往往导致角膜生物力学特性降低。随着角膜交联术应用于临床，紫外线A和核黄素产生化学反应，促进相邻的胶原纤维之间产生共价键，从而提高角膜的硬度，是目前提高角膜生物力学特性的最常用方式。The cornea acts as the outermost shell of the eye with elasticity and viscosity. The biome- chanical properties of the collagen fibers in the corneal stroma are important for maintaining the intrinsic mor- phology of the eyeball and protecting the inner structure. The main pathological changes of keratoconus was the corneal stroma thinning, Bowman membrane rupture and the iron deposit in the basal membrane of the corneal epithelium. Influenced by the long-term high intraocular pressure, the function of corneal transparent pump function and barrier is significantly affected, resulting in the collagen fibrous edema. Refractive sur- gery mainly aims at corneal stroma ablation, resulting the thinning of corneal thickness and destruction of collagen fiber morphology. Mechanical damage, such as ultrasonic energy, liquid perfusion and lens nucleus collision usually causes corneal injury in phacoemulsification. The above-mentioned changes lead to the re- duction of corneal biomechanics. With the application of corneal collagen cross-linking in clinical work, it has been proved to be the most commonly used way to improve corneal biomechanical properties.

关 键 词：角膜生物力学 屈光手术 青光眼 白内障 角膜胶原交联术 

分 类 号：R778.11[医药卫生—眼科]