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假性剥脱性青光眼单次选择性激光小梁成形术后的角膜内皮变化

Corneal endothelial changes following a single session of selective laser trabeculoplasty for pseudoexfoliative glaucoma.

作者信息

Örnek Nurgül, Örnek Kemal

机构信息

Department of Ophthalmology, School of Medicine, Kırıkkale University, Kırıkkale, Turkey.

Göz Hastalıkları Anabilim Dalı, Kırıkkale Üniversitesi Tıp Fakültesi, 71450, Yahşihan, Kırıkkale, Turkey.

出版信息

Int Ophthalmol. 2018 Dec;38(6):2327-2333. doi: 10.1007/s10792-017-0730-0. Epub 2017 Oct 13.

Abstract

PURPOSE

To evaluate corneal endothelial cell parameters after a single session of selective laser trabeculoplasty (SLT) in pseudoexfoliative glaucoma (PEG) patients.

METHODS

Corneal endothelial cell parameters of 18 PEG patients were compared with 18 healthy subjects following SLT treatment. All patients underwent SLT treatment to 180 degrees of inferior trabecular meshwork. Corneal measurements were performed using specular microscopy (Noncon Robo SP8000, Konan Medical, Hyogo, Japan). Endothelial cell density (ECD), hexagonal cell ratio (HEX), coefficient of variation (CV) of the corneal endothelial cell layer and central corneal thickness of the patients were measured at each visit.

RESULTS

There was a statistically significant decrease in ECD (p = 0.004) and a statistically significant increase in CV (p = 0.041) at superior cornea 1 week after SLT. They returned to pre-SLT values at 1 month. One hour post-SLT HEX of inferior cornea was statistically significantly reduced (p = 0.01). At central cornea, there was a significant increase in HEX after 1 week (p = 0.001). Post-SLT IOP showed a significant positive correlation with CV and significant negative correlation with HEX at superior and inferior cornea. There was no correlation between total laser energy used and endothelial cell parameters.

CONCLUSION

Effect of a single session of SLT on corneal endothelium of PEG patients appears to be transient, and superior cornea was more affected than central and inferior cornea. All parameters returned to pre-SLT values at 1 month after treatment.

摘要

目的

评估假性剥脱性青光眼(PEG)患者单次选择性激光小梁成形术(SLT)后的角膜内皮细胞参数。

方法

将18例PEG患者在SLT治疗后的角膜内皮细胞参数与18例健康受试者进行比较。所有患者均接受了180度下方小梁网的SLT治疗。使用镜面显微镜(日本兵库县小南医疗株式会社生产的Noncon Robo SP8000)进行角膜测量。每次就诊时测量患者的角膜内皮细胞密度(ECD)、六边形细胞比例(HEX)、角膜内皮细胞层的变异系数(CV)和中央角膜厚度。

结果

SLT术后1周,上方角膜的ECD有统计学意义的下降(p = 0.004),CV有统计学意义的增加(p = 0.041)。它们在1个月时恢复到SLT术前的值。SLT术后1小时,下方角膜的HEX有统计学意义的降低(p = 0.01)。在中央角膜,1周后HEX有显著增加(p = 0.001)。SLT术后眼压与上方和下方角膜的CV呈显著正相关,与HEX呈显著负相关。所用的总激光能量与内皮细胞参数之间没有相关性。

结论

单次SLT对PEG患者角膜内皮的影响似乎是短暂的,上方角膜比中央和下方角膜受影响更大。治疗后1个月所有参数均恢复到SLT术前的值。

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