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角膜密度测定:定量评估白内障玻璃体切除术后角膜变化的创新方法。

Corneal densitometry: an innovative method to quantitatively evaluate corneal changes after phacovitrectomy.

机构信息

Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai, 200000, China.

Department of Ophthalmology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.

出版信息

BMC Ophthalmol. 2023 Mar 6;23(1):87. doi: 10.1186/s12886-023-02818-3.

Abstract

BACKGROUND

To quantitatively investigate corneal changes and the correlation between corneal densitometry (CD) and endothelial parameters after phacovitrectomy.

METHODS

Thirty-eight eyes with idiopathic full-thickness macular holes (iFTMHs) and cataracts underwent phacovitrectomy. Examinations were conducted at baseline and Day 1, Day 7, Month 1, and Month 3 postoperatively. CD and central corneal thickness (CCT) were measured using Pentacam. Corneal endothelial cell density (ECD), coefficient of variation (CV), and hexagonality (HEX) were measured using specular microscopy.

RESULTS

ECD and HEX significantly decreased after surgery and the change in HEX occurred prior to CV. CCT increased immediately after surgery and recovered 3 months postoperatively. CD values increased significantly 1 day after surgery and then gradually decreased. For CD in the 0-2 mm zone, it took 1 month to recover in the central and posterior layers and 3 months in the anterior and total layers. For CD in the 2-6 mm zone, the central layer recovered at Day 7, the anterior and total layers recovered at 1 month, and the posterior layer did not recover until 3 months postoperatively. The CD within all layers in the 0-2 mm zone was positively correlated with CCT. Posterior CD in the 0-2 mm zone was negatively correlated with ECD and HEX.

CONCLUSIONS

CD is not only correlated with CCT, ECD, and HEX but also reflects the state of the whole cornea and each layer. CD can be an objective, rapid, and noninvasive tool that reflects corneal health and undetectable edema and monitors the process of lesion repair.

TRIAL REGISTRATION

This study was registered with the Chinese Clinical Trial Registry (31/10/2021, ChiCTR2100052554).

摘要

背景

定量研究白内障超声乳化吸除联合玻璃体切割术后角膜的变化以及角膜密度(CD)与内皮参数之间的相关性。

方法

38 例特发性全层黄斑裂孔(iFTMH)伴白内障患者接受白内障超声乳化吸除联合玻璃体切割术。术前及术后第 1、7、1 个月和 3 个月进行检查。采用 Pentacam 测量角膜 CD 和中央角膜厚度(CCT),采用角膜内皮显微镜测量角膜内皮细胞密度(ECD)、变异系数(CV)和六边形细胞比例(HEX)。

结果

术后 ECD 和 HEX 显著降低,HEX 的变化先于 CV。术后即刻 CCT 增加,术后 3 个月恢复。术后 1 天 CD 值显著升高,然后逐渐降低。0-2mm 区 CD 值在中央和后层中,1 个月恢复,在前层和总层中 3 个月恢复;2-6mm 区 CD 值在中央层中术后第 7 天恢复,在前层和总层中 1 个月恢复,而后层直到术后 3 个月才恢复。0-2mm 区各层的 CD 值与 CCT 呈正相关。0-2mm 区后层 CD 值与 ECD 和 HEX 呈负相关。

结论

CD 不仅与 CCT、ECD 和 HEX 相关,还反映了整个角膜和各层的状态。CD 可以作为一种客观、快速、非侵入性的工具,反映角膜健康和不可察觉的水肿,并监测病变修复过程。

试验注册

本研究在中国临床试验注册中心注册(31/10/2021,ChiCTR2100052554)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7954/9987054/284bc09d5692/12886_2023_2818_Fig1_HTML.jpg

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