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[放射状角膜切开术后角膜内皮细胞的长期变化]

[Long-term changes of corneal endothelial cells with radial keratotomy].

作者信息

Zhao Lu, Wang Yan-ling, Liu Ping, Liu Xuan

机构信息

Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2008 Jun;44(6):511-6.

Abstract

OBJECTIVE

To investigate the long-term loss and variation of corneal endothelial cells after radial keratotomy.

METHODS

By the way of case-control study, 51 myopia (101 eyes) patients who underwent RK in Beijing Friendship hospital, from January 1989 to December 1996 is the RK group. 51 myopia (102 eyes) outpatients who have no other eye diseases is the control group. The volunteers are the outpatients of Department of Ophthalmology in Beijing Friendship Hospital from November 2006 to March 2007. Corneal endothelial cells are examined by Topcon SP2000 non-contact corneal endothelial microscope. To survey corneal endothelium of center, superior, inferior, temple side and nasal side, to study endothelial cell density, average areas, coefficient of cell variation in size and hexagonality.

RESULTS

The differences of endothelial cell density, average areas, hexagonality are no significant between the RK group and the control group with the same age stage (P > 0.05). The differences of coefficient of cell variation are significant. In the 30 year old stage, the result of center is t = 3.742, P = 0.000, the result of superior is t = 3.627, P = 0.000, the result of inferior is t = 3.180, P = 0.002, the result of nasal side is t = 2.448, P = 0.016, the result of temple side is t = 3.149, P = 0.002. In the 40 year old stage, the result of center is t = 4.446, P = 0.000, the result of superior is t = 2.444, P = 0.017, the result of inferior is t = 2.113, P = 0.038, the result of nasal side is t = 3.214, P = 0.002, the result of temple side is t = 2.680, P = 0.009. In the 50 year old stage, the result of center is t = 2.360, P = 0.024, the result of superior is t = 2.600, P = 0.013, the result of inferior is t = 2.787, P = 0.008, the result of nasal side is t = 2.144, P = 0.038, the result of temple side is t = 2.177, P = 0.036. But the differences of coefficient of cell variation have no relationship with the time of RK (P > 0.05). The differences of endothelial cell density, average areas, coefficient of cell variation in size and hexagonality are no significant among different incision group (P > 0.05). There are impalpable changes in the morphology of endothelial cells, coefficient of cell variation in size is greater than the control with the same age stage.

CONCLUSION

If proforming other eye operations to RK patients, it is necessary to evaluate the corneal endothelial cells before operations.

摘要

目的

探讨放射状角膜切开术后角膜内皮细胞的长期丢失及变化情况。

方法

采用病例对照研究方法,选取1989年1月至1996年12月在北京友谊医院接受放射状角膜切开术的51例近视患者(101只眼)作为放射状角膜切开术组。选取51例无其他眼部疾病的近视门诊患者(102只眼)作为对照组。研究对象为2006年11月至2007年3月在北京友谊医院眼科门诊的患者。采用Topcon SP2000非接触式角膜内皮显微镜检查角膜内皮细胞。测量中央、上方、下方、颞侧和鼻侧的角膜内皮,研究内皮细胞密度、平均面积、细胞大小变异系数和六角形细胞比例。

结果

放射状角膜切开术组与同年龄阶段对照组在内皮细胞密度、平均面积、六角形细胞比例方面差异无统计学意义(P>0.05)。细胞大小变异系数差异有统计学意义。在30岁阶段,中央t=3.742,P=0.000;上方t=3.627,P=0.000;下方t=3.180,P=0.002;鼻侧t=2.448,P=0.016;颞侧t=3.149,P=0.002。在40岁阶段,中央t=4.446,P=0.000;上方t=2.444,P=0.017;下方t=2.113,P=0.038;鼻侧t=3.214,P=0.002;颞侧t=2.680,P=0.009。在50岁阶段,中央t=2.360,P=0.024;上方t=2.600,P=0.013;下方t=2.787,P=0.008;鼻侧t=2.144,P=0.038;颞侧t=2.177,P=0.036。但细胞大小变异系数的差异与放射状角膜切开术时间无关(P>0.05)。不同切口组在内皮细胞密度、平均面积、细胞大小变异系数和六角形细胞比例方面差异无统计学意义(P>0.05)。内皮细胞形态有细微变化,细胞大小变异系数大于同年龄阶段对照组。

结论

对放射状角膜切开术患者进行其他眼部手术时,术前有必要评估角膜内皮细胞情况。

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