摘要
目的利用激光共焦显微镜观察近视激光术后的haze结构。方法选取Epi-LASIK术后发生haze患者12例(24眼)设为A组,另选择接受Epi-LASIK但无并发症发生患者10例(20眼)设为B组,行双眼激光共焦显微镜检查,观察A组患者角膜上皮层、前基质层、中后基质层变化,并比较两组各层细胞密度。结果 A组角膜上皮基底膜缺如,上皮下散在斑点状瘢痕及高反光白色小点,瓣边缘见环形瘢痕,周边上皮细胞核呈高反光。角膜前基质层纤维紊乱,局部见空泡样改变及大量点状、斑片状瘢痕组织,近上皮瓣基底部大片瘢痕,其间可见细小皱褶;瘢痕间少量神经末梢走行,神经组织纤细,局部可见断裂、扭曲。中、后基质层见正常网状结构,内皮细胞"六边形"结构正常。A组角膜上皮层细胞密度为(6381.9±290.1)mm(-2),前基质层细胞密度为(482.6±53.3)mm(-2),对照组分别为(4729.1±319.2)mm(-2)和(372.4±41.2)mm(-2),两组相比差异均有统计学意义(均为P<0.05);A组中、后基质层和内皮层的细胞密度分别为(278.0±41.1)mm(-2)、(188.2±22.0)mm(-2)、(3290.1±339.2)mm(-2),对照组分别为(301.3±49.3)mm(-2)、(197.6±28.1)mm(-2)、(3102.3±322.0)mm(-2),两组相比差异均无统计学意义(均为P>0.05)。结论激光共焦显微镜可用于近视激光术后haze结构的观察评估。
Objective To observe the histological changes of the haze after LASIK or Epi-LASIK by laser confocal microscope. Methods Twelve cases（24 eyes） developed haze after Epi-LASIK surgeries（ group A） and 10 cases（20 eyes） had normal recovery after the surgeries （group B） were chosen. Laser confocal microscopic exami- nations were given 6 months to 2 years after the surgeries. The corneal epithelial layer, anterior stroma layer, posterior and middle stroma layer in group A were observed, and the cell densities in two groups were measured and compared. Results In group A, scars and white blots existed beneath the epithelium, a ring-shape scar existed in the flap rim,the anterior stroma changed like buble, and a large area of scars existed with some fractured or defective nerve terminals. The middle, posterior stroma and endotheli- al layer remained normal structure. The cell densities of epithelial layer and anterior stroma layer in group A were （ 6381.9 ±290.1 ） mm - 2, （482.6 ± 53.3 ） inm - 2, respective- ly, which in group B were （ 4729.1± 319.2 ） mm - 2, （ 372.4 ± 41.2 ） nun - 2, respectively, there were statistical differences （ all P 〈 0.05 ）. The cell densities of middle, posterior stroma layer and endothelial layer in group A were （ 278.0± 41. 1 ） mm-2, （ 188.2± 22. 0）mm-2 and （3290.1 ±339.2）mm-2 ,respectively,which in group B were （301.3 ± 49.3 ） mm -2, （ 197.6 ±28.1 ） mm -2 and （ 3102.3 ± 322.0 ） mm-2, respectively, there was no statistical difference between two groups （ all P 〉 0.05 ）. Conclusion Laser confo- cal microscope can be used for observing and evaluating the histological changes of haze after Epi-LASIK.
出处
《眼科新进展》
CAS
北大核心
2013年第3期240-242,共3页
Recent Advances in Ophthalmology
基金
国家自然科学基金面上项目资助(编号:30670600)~~
