Tsubota K, Yamada M, Naoi S
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.
Ophthalmology. 1991 Feb;98(2):184-91. doi: 10.1016/s0161-6420(91)32318-2.
The diameter of the cone lens of the specular microscope was enlarged from its original size of 3.5 mm to 6.0 mm. This modification enabled the authors to take clear pictures of the corneal epithelium with a specular microscope (SM) contact lens, because tears could be excluded from the photographic field by exerting even pressure on the cornea. The normal corneal epithelium showed three kinds of cells with no abnormally shaped or reflex cells. As spindle-shaped cells were mainly observed in keratoconus patients, post-penetrating keratoplasty patients, and postepikeratophakia patients, this suggests that these cells may be an indicator of wound healing. Large cells were observed in diabetic aphakic patients, aphakic extended-wear soft contact lens wearers, and aphakic patients using 0.5% indomethacin eye drops; thus, the presence of large cells may indicate suppressed metabolism and mitosis. Colonies of small cells were observed in keratoconjunctivitis patients. Cells with nuclei and irregular cell patterns were observed in all diseased conditions. There are several common abnormal patterns in the corneal epithelium that are observable under the specular microscope. Modified specular microscopic observation can detect these subtle alterations at the cellular level.
镜面显微镜的圆锥透镜直径从原来的3.5毫米扩大到了6.0毫米。这一改进使作者能够使用镜面显微镜（SM）隐形眼镜拍摄清晰的角膜上皮照片，因为通过对角膜施加均匀压力，可以将眼泪排除在拍摄视野之外。正常角膜上皮显示出三种细胞，没有形状异常或有反射的细胞。由于在圆锥角膜患者、穿透性角膜移植术后患者和表面角膜镜片术后患者中主要观察到纺锤形细胞，这表明这些细胞可能是伤口愈合的一个指标。在糖尿病无晶状体患者、无晶状体长期佩戴软性隐形眼镜者以及使用0.5%吲哚美辛滴眼液的无晶状体患者中观察到了大细胞；因此，大细胞的存在可能表明代谢和有丝分裂受到抑制。在角结膜炎患者中观察到了小细胞集落。在所有疾病状态下均观察到有细胞核和不规则细胞模式的细胞。在镜面显微镜下可观察到角膜上皮中有几种常见的异常模式。改进后的镜面显微镜观察能够在细胞水平上检测到这些细微变化。
