Tseng S H, Yu C H, Wang S T
Department of Ophthalmology, National Cheng Kung University Hospital, Tainan, Taiwan, R.O.C.
J Formos Med Assoc. 1995 Jun;94 Suppl 1:S20-5.
It is difficult to perform specular microscopic observation of the corneal epithelium in vivo due to the interference of light scattering by the tear film layer. In this study, we clearly observed the morphology of superficial corneal epithelial cells with a specular microscope contact lens that has the same refractive index as the corneal tissue. A total of 61 corneas from normal subjects and 21 corneas from soft contact lens wearers who had worn their lenses on a regular daily basis were studied using a specular microscope to take pictures of the corneal epithelium. The pictures were then analyzed with a computer-assisted morphometric analysis system. In normal subjects, the mean epithelial cell area and corresponding mean coefficient of variation (CV) were 618 +/- 97 microns 2 and 30.7 +/- 5.0% respectively. There was a significant correlation between the mean epithelial cell area and age in male group (p < 0.05) but not in the female group; whereas a significant correlation existed between CV and age in the female group only (p < 0.05). In the soft contact lens group, the mean epithelial cell area was 675 +/- 143 micron 2 and the CV was 29.6 +/- 6.0%. Compared to the corneal epithelium of normal subjects, the epithelial cell area and CV in the soft contact lens group was not significantly different; however, abnormal morphologic patterns in the corneal epithelium appeared more frequently. Our study showed that modified specular microscopy is a noninvasive and clinically valuable method by which to assess subtle alterations in the corneal epithelium that are barely detectable with routine slit lamp biomicroscopy.
由于泪膜层的光散射干扰，在活体状态下对角膜上皮进行镜面显微镜观察很困难。在本研究中，我们使用与角膜组织具有相同折射率的镜面显微镜隐形眼镜，清晰地观察到了浅表角膜上皮细胞的形态。使用镜面显微镜对61只来自正常受试者的角膜以及21只来自每天规律佩戴软性隐形眼镜者的角膜进行研究，拍摄角膜上皮的照片。然后使用计算机辅助形态测量分析系统对这些照片进行分析。在正常受试者中，上皮细胞平均面积和相应的平均变异系数（CV）分别为618±97平方微米和30.7±5.0%。男性组中上皮细胞平均面积与年龄之间存在显著相关性（p<0.05），而女性组中不存在这种相关性；仅在女性组中CV与年龄之间存在显著相关性（p<0.05）。在软性隐形眼镜组中，上皮细胞平均面积为675±143平方微米，CV为29.6±6.0%。与正常受试者的角膜上皮相比，软性隐形眼镜组的上皮细胞面积和CV无显著差异；然而，角膜上皮的异常形态模式出现得更为频繁。我们的研究表明，改良的镜面显微镜检查是一种无创且具有临床价值的方法，可用于评估角膜上皮中常规裂隙灯生物显微镜几乎检测不到的细微变化。
