穿透性角膜移植术后的角膜上皮
Corneal epithelium following penetrating keratoplasty.
作者信息
Tsubota K, Mashima Y, Murata H, Yamada M, Sato N
机构信息
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.
出版信息
Br J Ophthalmol. 1995 Mar;79(3):257-60. doi: 10.1136/bjo.79.3.257.
AIMS
This study was designed to observe any changes to the corneal epithelium after penetrating keratoplasty.
METHODS
The corneal epithelia of 26 patients were observed by specular microscopy 1 week, 1 month, 3 months, and 6 months following penetrating keratoplasty.
RESULTS
After re-epithelialisation was confirmed by biomicroscopy 1 week after surgery, specular microscopy revealed many abnormal cells, including spindle shaped cells, nucleated cells, large cells, as well as irregular cell configurations. Although these abnormal findings tended to decrease with time, they were still present in some cases as much as 6 months postoperatively. Computerised morphometric analysis yielded mean cell areas of 1121 (SD 168) microns 2, 1139 (675) microns 2, 1712 (496) microns 2, and 1400 (377) microns 2 at 1 week, 1 month, 3 months, and 6 months respectively, all significantly greater than that of age matched controls (710 (151) microns 2). The shape factor decreased with time, but was still greater than the control level at 6 months.
CONCLUSIONS
This study demonstrates that epithelial abnormalities persist longer than expected after penetrating keratoplasty, and that these subtle changes can be detected by specular microscopic observation, potentially allowing for modification and enhancement of the wound healing process.
目的
本研究旨在观察穿透性角膜移植术后角膜上皮的任何变化。
方法
对26例患者的角膜上皮在穿透性角膜移植术后1周、1个月、3个月和6个月通过镜面显微镜进行观察。
结果
术后1周通过生物显微镜确认上皮化后，镜面显微镜显示许多异常细胞，包括纺锤形细胞、有核细胞、大细胞以及不规则的细胞形态。尽管这些异常表现随时间有减少趋势，但在术后6个月时仍有部分病例存在。计算机形态计量分析得出，在1周、1个月、3个月和6个月时的平均细胞面积分别为1121（标准差168）平方微米、1139（675）平方微米、1712（496）平方微米和1400（377）平方微米，均显著大于年龄匹配对照组（710（151）平方微米）。形状因子随时间下降，但在6个月时仍高于对照水平。
结论
本研究表明，穿透性角膜移植术后上皮异常持续时间比预期长，并且这些细微变化可通过镜面显微镜观察检测到，这可能有助于改进和加强伤口愈合过程。
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