圆锥角膜患者去上皮加速角膜交联术后早期的共聚焦显微镜改变  

The early changes in confocal microscopy of patients with keratoconus after epithelium-off accelerated corneal collagen cross-linking

作　　者：黎明 张醇 谢洪彬 汪家名 应方微 林宝涛 杨美娜 郭萍 聂丹瑶 LI Ming;ZHANG Chun;XIE Hongbin;WANG Jiaming;YING Fangwei;LIN Baotao;YANG Meina;GUO Ping;NIE Danyao(Shenzhen Eye Hospital,Joint College of Optometry of Shenzhen University,Affiliated Shenzhen Eye Hospital of Jinan University,Shenzhen Key Laboratory of Ophthalmology,Shenzhen 518040,China)

机构地区：[1]深圳市眼科医院,深圳大学眼视光学院,暨南大学附属深圳眼科医院,深圳眼科学重点实验室,广东深圳518040

出　　处：《中国实用眼科杂志》2018年第6期426-434,共9页Chinese Journal of Practical Ophthalmology

基　　金：深圳市科技计划项目基础研究(自由探索)(JCYJ20170306140020487,JCYJ20160428144605809);广东省自然科学基金项目(2015A030313774)

摘　　要：目的应用激光角膜共聚焦显微镜观察去上皮加速角膜交联术后患者角膜早期各层的改变。方法采用前瞻性自身对照系列病例观察研究设计,纳入2015年5月至2017年10月在深圳眼科医院就诊的圆锥角膜患者15例(23只眼),采用去上皮加速角膜交联术治疗,于术前及术后1d、3d、1周应用角膜激光共聚焦显微镜观察角膜各层的细胞改变。结果角膜激光共聚焦显微镜可以清晰观察去上皮加速角膜交联术后早期角膜上皮和前弹力层神经的修复过程,角膜基质形成交联带的显微结构及该手术对角膜内皮的影响。结论利用角膜激光共聚焦显微镜可以在去上皮加速角膜交联术后早期清晰观察角膜各层细胞的修复和改变,对临床治疗有重要的指导意义。Objective To observe the cell changes in early corneal layers with keratoconus after epithelium-off A-CXL by laser corneal confocal microscopy in vivo.Methods Fifteen patients(23 eyes)with keratoconus who were treated in Shenzhen Ophthalmic Hospital from May 2015 to May 2017 were enrolled in the prospective self-controlled series of case-observing study.The patients were treated with epithelium-off A-CXL,Corneal laser confocal microscopy in vivo was performed before,1 day after surgery,3 days after surgery and 1 week after surgery.Results Corneal laser confocal microscopy could clearly observe in vivo the repair process of early corneal epithelial and Bowman's membrane after epithelium-off A-CXL,the microstructure of corneal stroma forming crosslink and the effect of the operation on corneal endothelium.Conclusions Corneal laser confocal microscopy can clearly observe the repair and alteration of corneal cells in the early phase of epithelium-off A-CXL in vivo,which has important guiding significance for clinical treatment.

关 键 词：共聚焦显微镜 圆锥角膜 去上皮加速角膜交联术 

分 类 号：R77[医药卫生—眼科]