摘要
目的通过观察机械法准分子激光角膜上皮瓣下磨镶术对角膜内皮细胞的影响,研究它的安全性和可靠性。方法选择锦州医科大学附属第三医院眼科门诊确诊为近视的患者40例(80只眼),近视度数为-5.00 D~-15.00 D,年龄为21~35岁,其中男性21人,女性19人,利用超生测厚系统测量切削面距离内皮细胞层的厚度分为两组:A组厚度350~400μm,B组厚度275~350μm,两组均采取同样的处理措施,术前、术后1 w、术后4 w、术后12 w分别在裂隙灯下观察角膜;使用接触型角膜内皮反射显微照相系统定量分析中央角膜内皮细胞密度、细胞面积变异系数和六角形细胞百分比。结果裂隙灯观察术后角膜无水肿,角膜内皮无沉着物,房水无浮游物。接触型角膜内皮反射显微照相系统定量分析结果,术前与术后1 w、术后4 w、术后12 w内皮细胞密度、变异系数、六角形细胞百分比分别比较,差异无统计学意义(P>0.05);术后1 w、术后4 w、术后12 w角膜内皮细胞密度、变异系数的变化量与切削深度均差异无统计学意义(P>0.05);术后1 w、术后4 w六角形细胞百分比的变化量与切削深度比较,差异有统计学意义(P<0.05),呈正相关,术后12 w六角形细胞百分比的变化量与切削深度无统计学意义(P>0.05),无相关性;术后1 w、术后4 w、术后12 w角膜内皮细胞细胞密度、变异系数、六角形细胞百分比的变化量与切削面距离内皮细胞层的厚度均无统计学意义(P>0.05),无统计学的相关性。结论机械法准分子激光角膜上皮瓣下磨镶术是一种安全、可靠的准分子激光手术,术后未造成角膜内皮细胞的丢失,细胞形态也未发生变化,必然会被越来越多的近视患者所接受。
Objective To study the safety and reliability of mechanical epipolis-laser in situ keratomileusis by observing its effect on corneal endothelial cells.Methods 40 patients(80 eyes)with myopia were selected from the Ophthalmology Clinic of the Third Affiliated Hospital of Jinzhou Medical University.The myopic degree was-5.00 D to-15.00 D,including 21 males and 19 females,aged from 21 to 35 years.The thickness of the cut surface from the endothelial cell layer was measured by ultrathin thickness measurement system,and then divided into two groups.The thickness of group A was 350μm to 400μm,and the thickness of group B was 275μm to 350μm.The same treatment measures were taken in the two groups,and corneas were observed under a slit lamp before surgery and at 1 w,4 w,and 12 w after surgery.The central corneal endothelial cell density,the coefficient of variation of cell area and the percentage of hexagonal cells were quantified by contact corneal endothelial reflection microphotography system.Results Slit-lamp examination showed that there was no corneal edema,no sediment in the corneal endothelium,and no floating matter in the aqueous humor.The quantitative analysis results of contact corneal endothelial reflection microphotography system showed that there was no significant difference in endothelial cell density,coefficient of variation and percentage of hexagonal cells between preoperative and postoperative 1 w,4 w and 12 w(P>0.05).There was no significant difference in corneal endothelial cell density,coefficient of variation and ablation depth at 1 w,4 w and 12 w after surgery(P>0.05).The changes of the percentage of hexagonal cells at 1 w and 4 w after operation were statistically significant(P<0.05),and positively correlated with the ablation depth.The changes of the percentage of hexagonal cells at 12 w after operation were not significantly different from the ablation depth(P>0.05),and there was no correlation.There was no significant difference between the changes of corneal endothelial cell density,coefficient of variation,percentage of hexagonal cells and the thickness of endothelial cell layer from the cutting surface at 1 w,4 w and 12 w after surgery(P>0.05),and there was no statistically significant correlation.Conclusion Mechanical epipolis-laser in situ keratomileusis is a safe and reliable excimer laser surgery,which does not cause the loss of corneal endothelial cells and cell morphology does not change.It is bound to be accepted by more and more myopic patients.
作者
孙丽丽
张震
Sun Lili;Zhang Zhen(Ophthalmology Department of the Third Affiliated Hospital of Jinzhou Medical University;The Department of Ophthalmology,Central Hospital of Jinzhou,Jinzhou 121000 China)
出处
《锦州医科大学学报》
2022年第5期45-49,共5页
Journal of Jinzhou Medical University
基金
辽宁省自然科学基金面上项目,项目编号:2021-MS-327
锦州医科大学教学改革研究课题,项目编号:YB2022001
中国眼谷视功能诊疗技术与转化应用实验室资助项目,项目编号:202101。
作者简介
孙丽丽(1980),女,黑龙江绥化人,副主任医师,博士学位,主要研究方向为屈光、小儿斜弱视;通讯作者:张震(1980),男,山东潍坊人,副主任医师,硕士学位,主要研究方向为屈光、眼底病。
