摘要
目的探讨飞秒激光制瓣LASIK术中前房气泡对角膜内皮细胞的影响。设计回顾性病例系列。研究对象2012年2月-2017年11月解放军中部战区空军医院接受飞秒激光LASIK手术且发生前房气泡的23例(23眼)患者。方法将IntraLase飞秒激光制瓣LASIK术中发生前房气泡的眼作为观察组,对侧未发生前房气泡的眼作为对照组。将前房气泡量分为三级:Ⅰ级气泡量较少均位于瞳孔缘内,Ⅱ级气泡量中等已遮挡瞳孔缘,Ⅲ级气泡量多无法暴露瞳孔。于术前及术后1天、1周、1个月、3个月、6个月用非接触角膜内皮显微镜(TOPCON SP-2000P)测量两组的角膜中央区单位面积内角膜内皮细胞密度(CED)、六角形角膜内皮细胞(HEX)比率、角膜内皮细胞面积变异系数(CV)。主要指标CED、HEX比率、角膜内皮细胞面积CV。结果前房气泡产生自鼻侧房角11眼(47.83%)、不揣颞侧8眼(34.78%)、下方3眼(13.04%)、上方1眼(4.35%)。所有眼气泡均由房角移向瞳孔区。Ⅰ级、Ⅱ级、Ⅲ级气泡分别为15眼(65.22%)、7眼(30.43%)、1眼(4.35%)。观察组术前及术后1天、1周、1个月、3个月、6个月各时间点CED分别为(2901±180)个/mm^(2)、(2833±153)个/mm^(2)、(2852±149)个/mm^(2)、(2835±171)个/mm^(2)、(2863±117)个/mm^(2)、(2854±88)个/mm^(2);HEX比率分别为(45.2±5.4)%、(46.5±5.4)%、(46.2±5.4)%、(47.3±5.5)%、(47.6±4.7)%、(47.7±4.5)%;角膜内皮细胞面积CV分别为(45.17±5.39)%、(46.50±5.43)%、(46.22±5.43)%、(47.32±5.50)%、(47.62±4.68)%、(47.72±4.52)%。对照组术前及术后各时间点的CED分别为(2989±349)个/mm^(2)、(2948±246)个/mm^(2)、(2958±331)个/mm^(2)、(2972±321)个/mm^(2)、(2958±342)个/mm^(2)、(2962±355)个/mm^(2);HEX比率分别为(46.3±7.5)%、(44.1±8.2)%、(43.9±7.3)%、(43.7±7.4)%、(44.3±6.9)%、(43.9±7.1)%;角膜内皮细胞面积CV分别为(43.81±8.15)%、(46.41±6.37)%、(46.58±6.67)%、(46.73±7.12)%、(46.81±6.12)%、(46.76±7.06)%。CED组�
Objective To explore the influence on corneal endothelial cell of anterior chamber bubbles during femtosecond laser in situ keratomileusis(LASIK).Design Retrospective cases series.Participants Twenty-three patients(23 eyes with anterior chamber bubbles)in The Central Theater Command Air-Force Hospital of PLA from February 2012 to November 2017 who accept LASIK surgeries using femtosecond leaser.Methods The eyes with anterior chamber bubbles during IntraLase femtosecond laser LASIK were included in observation group,and the eyes without anterior chamber bubbles during LASIK were included in the control group.Anterior chamber bubbles based on the number of bubbles divided into first-level(a little bubbles in pupil area),second-level(medium dose bubbles covering pupil area)and third-level(a lot of bubbles covering completely pupil area).The mean central corneal endothelial cell density(CED),percentage of hexagonal endothelium(HEX)and coefficient of variation(CV)of corneal endothelial cell area measured by Topcon SP-2000P noncontact specular microscope of two groups were compared at preoperation,and at 1 day,1 week,1 month,3 months,6 months after operation.Main Outcome Measures CED,percentage of HEX and CV of corneal endothelial cell area.Resuits Anterior chamber bubbles located on nasal side in 11 eyes(47.83%),on bitamporal side in 8 eyes(34.78%),on below side in 3 eyes(13.04%)and on upward side in 1 eye(4.35%).All anterior chamber bubbles moved from anterior chamber angle to pupil.15 eyes(65.22%)were the first-level anterior chamber bubbles,7 eyes(30.43%)were the second-level and 1 eye(4.35%)was the third-level.The CED of observation group at preoperative and postoperative 1 day,1 week,1 month,3 months,6 months was 2901±180 cells/mm^(2),2833±153 cells/mm^(2),2852±149/mm^(2),2835±171 cells/mm^(2),2863±117 cells/mm^(2) and 2854±88 cells/mm^(2),respectively.The percentage of HEX of observation group at preoperative and postoperative 1 day,1 week,1 month,3 months,6 months was 45.2%±5.4%,46.5%±5.4%,46.2%±5.4%,4
作者
王兴存
张广峰
朱立强
何皎
Wang Xingcun;Zhang Guangfeng;Zhu Liqiang;He Jiao(Department of Ophthalmology,the Central Theater Command Air-Force Hospital of PLA,Datong Shanxi 037047,China)
出处
《眼科》
CAS
2021年第5期360-366,共7页
Ophthalmology in China
关键词
飞秒激光
准分子激光原位角膜磨镶术
前房气泡
并发症
femtosecond laser
laser in situ keratomileusis
anterior chamber bubbles
complication
