MacRae S M, Rich L F
Casey Eye Institute, Department of Ophthalmology, Oregon Health Sciences University, Portland 97201, USA.
J Refract Surg. 1998 Jan-Feb;14(1):49-52. doi: 10.3928/1081-597X-19980101-10.
The long-term effects of radial keratotomy on the corneal endothelium are not well understood. We evaluated the effects of radial keratotomy on the corneal endothelium on the central and midperipheral corneal endothelium.
Anterior radial keratotomy in 25 eyes was performed and patients were followed for a duration of 4 to 10 years after surgery. Eleven non- contact lens wearing control eyes did not have surgery and were followed for the same period. Morphometric analysis of specular microscopic images was performed with regard to cell density, percent hexagonality, and coefficient of variation.
Mean corneal endothelial cell loss rates were 0.4% per year in the radial keratotomy group and 0.9% in the untreated control group over the study duration (mean 7 yr). Morphometric analysis of the cells failed to show a significant change in hexagonality and coefficient of variation. Evaluation of the midperipheral corneal cell counts demonstrated a 1% per year cell loss rate. The cell loss rates in radial keratotomy patients followed over this period were consistent with that noted for normal aging (0.5 to 2.5% per year).
Radial keratotomy does not cause accelerated endothelial cell loss over 4 to 10 years.
放射状角膜切开术对角膜内皮的长期影响尚未完全明确。我们评估了放射状角膜切开术对中央和中周边角膜内皮的影响。
对25只眼进行了前放射状角膜切开术，并对患者术后4至10年进行随访。11只未佩戴隐形眼镜的对照眼未接受手术，随访时间相同。对镜面显微镜图像进行形态计量分析，包括细胞密度、六边形细胞百分比和变异系数。
在研究期间（平均7年），放射状角膜切开术组角膜内皮细胞平均每年丢失率为0.4%，未治疗的对照组为0.9%。对细胞的形态计量分析未显示六边形细胞百分比和变异系数有显著变化。对中周边角膜细胞计数的评估显示每年细胞丢失率为1%。在此期间随访的放射状角膜切开术患者的细胞丢失率与正常衰老的情况一致（每年0.5%至2.5%）。
放射状角膜切开术在4至10年内不会导致内皮细胞加速丢失。
