Mardelli P G, Piebenga L W, Matta C S, Hyde L L, Gira J
University of Missouri-Kansas City School of Medicine, Department of Ophthalmology, Eye Foundation of Kansas City 64108, USA.
Ophthalmology. 1995 Apr;102(4):544-9; discussion 548-9. doi: 10.1016/s0161-6420(95)30984-0.
To investigate the long-term effect (range, 12-55 months) of photorefractive keratectomy (PRK) on the human corneal endothelium.
Specular microscopy of the central corneal endothelium was performed on 106 patients who underwent PRK to correct myopia. The duration of follow-up varied from 12 to 55 months (mean, 33 months; median, 37 months). Patients were divided in two groups: group 1 included 32 patients (35 treated eyes) with preoperative and postoperative central endothelial images; group 2 included 26 patients from group 1 and 74 additional patients with postoperative central endothelial images of the treated and untreated fellow eyes.
In group 1, preoperative and postoperative values were as follows: mean cell density (+/- standard deviation), 2950 +/- 329 cells/mm2 and 2907 +/- 337 cells/mm2, respectively (P = 0.43); polymegathism index, 0.29 +/- 0.06 and 0.28 +/- 0.05, respectively (P = 0.38); pleomorphism index, 65.8% +/- 5.6% and 64.2% +/- 5.6%, respectively (P = 0.22); figure coefficient index, 0.86 +/- 0.05 and 0.87 +/- 0.02, respectively (P = 0.20). In group 2, postoperative values of the treated and untreated eyes were as follows: mean cell density, 2912 +/- 363 cells/mm2 and 2922 +/- 434 cells/mm2, respectively (P = 0.86); polymegathism index, 0.28 +/- 0.05 and 0.30 +/- 0.08, respectively (P = 0.04); pleomorphism index, 64.93% +/- 7.49% and 64.07% +/- 8.31%, respectively (P = 0.45); figure coefficient index, 0.88 +/- 0.03 and 0.88 +/- 0.03, respectively (P = 0.79).
Photorefractive keratectomy caused no damage to the central corneal endothelium. Polymegathism differences in treated and untreated eyes could be attributed to modifications in corneal metabolism or to a yet unknown mechanism.
研究准分子激光角膜切削术（PRK）对人角膜内皮的长期影响（范围为12 - 55个月）。
对106例行PRK矫正近视的患者进行中央角膜内皮的镜面反射显微镜检查。随访时间从12个月到55个月不等（平均33个月；中位数37个月）。患者分为两组：第1组包括32例患者（35只治疗眼），有术前和术后中央内皮图像；第2组包括第1组的26例患者以及另外74例有治疗眼和未治疗对侧眼术后中央内皮图像的患者。
在第1组中，术前和术后的值如下：平均细胞密度（±标准差）分别为2950±329个细胞/mm²和2907±337个细胞/mm²（P = 0.43）；大小不均一指数分别为0.29±0.06和0.28±0.05（P = 0.38）；多形性指数分别为65.8%±5.6%和64.2%±5.6%（P = 0.22）；形态系数指数分别为0.86±0.05和0.87±0.02（P = 0.20）。在第2组中，治疗眼和未治疗眼的术后值如下：平均细胞密度分别为2912±363个细胞/mm²和2922±434个细胞/mm²（P = 0.86）；大小不均一指数分别为0.28±0.05和0.30±0.08（P = 0.04）；多形性指数分别为64.93%±7.49%和64.07%±8.31%（P = 0.45）；形态系数指数分别为0.88±0.03和0.88±0.03（P = 0.79）。
准分子激光角膜切削术未对中央角膜内皮造成损伤。治疗眼和未治疗眼之间大小不均一性的差异可能归因于角膜代谢的改变或一种尚不清楚的机制。
