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水激光液化白内障摘除术后角膜的共聚焦显微镜评估

Confocal microscopic evaluation of cornea after AquaLase liquefaction cataract extraction.

作者信息

Zhao Jiang-Yue, Wang Ming-Wu, Sun Qi, Zhang Jin-Song

机构信息

Eye Hospital of China Medical University; Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University; Provincial Key Laboratory of Lens Research, Liaoning, China.

出版信息

Int J Ophthalmol. 2011;4(3):293-7. doi: 10.3980/j.issn.2222-3959.2011.03.17. Epub 2011 Jun 18.

Abstract

AIM

The most recent and innovative AquaLase liquefaction technology has offered an alternative to lens extraction. Many studies have investigated its functions and advantages. This article focuses on evaluating the in vivo microscopic cornea changes after AquaLase liquefaction by using a laser confocal microscope.

METHODS

In this perspective, randomized case study, 37 eyes of 35 patients submitted to cataract surgery were chosen to undergo AquaLase liquefaction cataract extraction. Each patient was assessed before the operation, on the 1(st), 7(th), and 30(th) postoperative days, and 6 months after the cataract extraction. The morphologies and quantitative comparisons of corneal cells and corneal nerves layer by layer were evaluated in vivo with the Heidelberg Retina Tomograph III-Rostock Cornea Module (HRT-III RCM) confocal microscope. ANOVA and Post-Hoc Bonferroni test were carried out to compare the results pre- and post-operation.

RESULTS

ANOVA results indicated no post-operation changes for epithelium and anterior stroma cells. Irregular segments of sub-basal nerve fiber were most pronounced seven days post-operation. In the mid and posterior stroma, keratocytes were obvious compared with the preoperative condition. Corneal endothelium cells became obviously swollen in cytoplasm and nucleus. The mid and posterior stroma cell density decreased from the 1(st) to 7(th) postoperative days (P<0.05). The corneal endothelium cell density decreased (P<0.05) and did not revert to the preoperative level after six months (P<0.05).

CONCLUSION

Slight microstructural abnormalities were identified in the corneal recovery process after AquaLase liquefaction. AquaLase liquefaction cataract extraction is safe for cornea.

摘要

目的

最新的创新性水激光液化技术为晶状体摘除提供了一种替代方法。许多研究已经对其功能和优势进行了调查。本文重点通过激光共聚焦显微镜评估水激光液化后体内角膜的微观变化。

方法

在这项前瞻性随机病例研究中,选择35例接受白内障手术的患者的37只眼进行水激光液化白内障摘除术。在手术前、术后第1天、第7天、第30天以及白内障摘除术后6个月对每位患者进行评估。使用海德堡视网膜断层扫描仪III - 罗斯托克角膜模块(HRT - III RCM)共聚焦显微镜在体内逐层评估角膜细胞和角膜神经的形态及定量比较。采用方差分析和事后邦费罗尼检验比较手术前后的结果。

结果

方差分析结果表明上皮细胞和前基质细胞术后无变化。术后7天基底膜下神经纤维的不规则节段最为明显。在基质中部和后部,与术前相比,角膜细胞明显可见。角膜内皮细胞的细胞质和细胞核明显肿胀。术后第1天至第7天,基质中部和后部的细胞密度降低(P<0.05)。角膜内皮细胞密度降低(P<0.05),且6个月后未恢复到术前水平(P<0.05)。

结论

水激光液化后角膜恢复过程中存在轻微的微观结构异常。水激光液化白内障摘除术对角膜是安全的。

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本文引用的文献

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