小梁切除术对角膜内皮细胞丢失的影响。
Effect of trabeculectomy on corneal endothelial cell loss.
机构信息
Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
Ophthalmology, Kagawa University, Miki, Japan.
出版信息
Br J Ophthalmol. 2020 Mar;104(3):376-380. doi: 10.1136/bjophthalmol-2018-313417. Epub 2019 Jun 14.
AIM
To investigate changes in corneal endothelial cell density (CECD) after trabeculectomy.
METHODS
This prospective, observational study followed 117 eyes of 117 patients for 2 years after trabeculectomy. The central cornea was examined by corneal specular microscopy prior to and at every 6 months after the surgery. Survival analysis of patients who exhibited a 10% or less reduction of the postoperative CECD compared with preoperative levels was assessed using the Kaplan-Meier survival curve. A Cox proportional hazards model was used to evaluate prognostic factors for decreasing CECD.
RESULTS
At baseline, the mean CECD was 2420±357 cells/mm, while at 6, 12, 18 and 24 months after surgery, the mean CECD was 2324±373 cells/mm (p<0.001), 2276±400 cells/mm (p<0.001), 2290±398 cells/mm (p<0.001) and 2267±446 cells/mm (p<0.001), respectively. At 6, 12, 18 and 24 months after surgery, the results of the Kaplan-Meier survival analysis of the 10% loss of CECD from baseline were 91%, 85%, 83% and 77%, respectively. Uveitic glaucoma was a significant prognostic factor for decreasing CECD (p=0.041).
CONCLUSIONS
CECD significantly and continuously decreased after trabeculectomy.
目的
研究小梁切除术后角膜内皮细胞密度（CECD）的变化。
方法
本前瞻性观察研究随访了 117 例 117 只眼，在小梁切除术后 2 年内每 6 个月检查一次中央角膜。手术前后均采用角膜共焦显微镜检查中央角膜。采用 Kaplan-Meier 生存曲线评估术后 CECD 较术前减少 10%或更少的患者生存情况。采用 Cox 比例风险模型评估 CECD 下降的预后因素。
结果
基线时，平均 CECD 为 2420±357 个细胞/mm，术后 6、12、18 和 24 个月时，平均 CECD 分别为 2324±373 个细胞/mm（p<0.001）、2276±400 个细胞/mm（p<0.001）、2290±398 个细胞/mm（p<0.001）和 2267±446 个细胞/mm（p<0.001）。术后 6、12、18 和 24 个月时，Kaplan-Meier 生存分析结果显示，CECD 从基线下降 10%的结果分别为 91%、85%、83%和 77%。葡萄膜炎性青光眼是 CECD 下降的显著预后因素（p=0.041）。
结论
小梁切除术后 CECD 显著且持续下降。
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