穿透性角膜移植术后共焦显微镜下角膜移植片内皮细胞异常研究  

Observation of abnormal endothelial cells of corneal graft under confocal microscope after penetrating keratoplasty

作　　者：侯飞[1] 黎明[1] 方敏[1] Hou Fei;Li Ming;Fang Min(Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen 518040, China)

机构地区：[1]暨南大学附属深圳市眼科医院深圳眼科学重点实验室,深圳518040

出　　处：《新医学》2017年第7期492-494,共3页Journal of New Medicine

基　　金：深圳市卫生计生系统科研项目(201401064)

摘　　要：目的分析穿透性角膜移植术后共焦显微镜下角膜移植片的内皮细胞异常显现情况。方法收集行穿透性角膜移植术患者共40例(40眼)作为研究对象。根据是否有内皮细胞异常显现分为观察组(有异常)20眼、对照组(无异常)20眼,比较2组患眼在角膜形态学指标以及术后并发症发生率的差异。结果观察组的内皮细胞密度和六边形细胞比例均低于对照组(P均<0.01)。观察组的内皮细胞面积、六边形细胞变异率和内皮细胞丢失率均高于对照组(P均<0.01)。2组的角膜中央厚度比较差异无统计学意义(P>0.05)。观察组患眼术后继发性青光眼发生率为35%,一过性高眼压发生率为55%,均高于对照组(P均<0.05)。结论共焦显微镜检查可清晰显示穿透性角膜移植术后患者角膜移植片的内皮细胞异常状态,如检查结果提示患者角膜内皮形态结构有异常改变,其发生并发症的可能性高,需要引起临床重视。Objective To investigate abnormality of endothelial cell in the corneal graft under confocal microscope following penetrating keratoplasty.Methods Forty patients(40eyes)undergoing penetrating keratoplasty were recruited in this study.All participants were assigned into the observation and control groups.The corneal morphological parameters and the incidence of postoperative complications were statistically compared between two groups.Results In the observation group,the endothelial cell density and the percentage of hexagonal cells were significantly lower compared with those in control group(both P<0.01).In the observation group,the endothelial cell area,CV of hexagonality and endothelial cell loss rate were considerably higher than those in the control group(all P<0.01).No statistical significance was identified in terms of central corneal thickness between two groups(P>0.05).In the observation group,postoperative incidence of secondary glaucoma was35%,and55%for transient ocular hypertension,significantly higher compared with those in the control group(both P<0.05).Conclusions Confocal microscope explicitly displays the endothelial cell abnormality in the corneal graft after penetrating keratoplasty.Observation of morphological changes in the corneal endothelial cells is suggestive of a high incidence of postoperative complications,which captivates widespread attention from the clinicians.

关 键 词：穿透性角膜移植术 共焦显微镜 角膜移植片 内皮细胞 

分 类 号：R779.65[医药卫生—眼科]