LASIK术后远期角膜基质形态学改变活体共焦显微镜观察.docVIP

LASIK术后远期角膜基质形态学改变活体共焦显微镜观察 　 作者：乔丽萍，赵少贞，孙慧敏，袁佳琴 【摘要】 目的 应用共焦显微镜在细胞水平观察术后远期角膜基质形态学改变。方法 选择1999年4月17日～2002年7月31日期间在天津医科大学眼科中心屈光手术门诊行LASIK手术的患者34例(68眼)，术前平均球镜-6.81±2.88D(-3.0～16D)，平均24.17±5.93岁(18～42岁)； 术后平均随访时间为16±9.5个月(6～44个月)进行共焦显微镜观察。结果 LASIK术后远期，68眼(100%)中央角膜见到深度为44.01±10.67μm的低细胞区域。微皱折、异常颗粒长期存在，不随时间的延长而减少。角膜瓣与角膜基质床的贴附是非瘢痕性的。结论 LASIK术后远期，基质形态学发生改变。 【关键词】 角膜原位磨镶术 远期 角膜基质形态 共聚焦显微镜 Long-time follow-up study of the changes of morphology of central cornealafter LASIK using an in vivo confocal microscopy 【Abstract】 Objective To observe the morphology changes induced by myopic LASIK vary length of follow-up.Methods This study comprised 34 patients (68 eyes) who had undertook LASIK in ophthalmology center of Tianjin medical university from 1999 Apr.17 to 2002 Jul.31 (range from 6 to 44 months) were examined after operation using an in vivo confocal microscopy. The average spherical equivalent was -6.81±2.88D(range from -3.0 to-16D).The average age was (24.17±5.93) years old( range from 18 to 42 years old).The average follow-up time was (16±9.5) months(range from 6 to 44 months).Results The Microfolds at the Bowman?s layer were found in 68 eyes(100%)，as well as variously reflectivity particles located at the interface level in all eyes examined after operation. The density of high reflective particles had not decreased significantly with time .In the middle stroma，the mean depth of acellular area was (44.01±10.67) μm in all68eye100%).Conclusion Morphologic changes have showed in central cornea. Acellular area ，microfolds and as well as variously reflectivity particles located at the interface level in all eyes have existed in the central cornea for long time. 【Key words】 LASIK long-time the morphology of cornea confocal microscopy 共聚焦显微镜是一种高清晰度、高放大倍率、三维、实时对角膜光学断层扫描技术，可以从活体上在细胞水平观察到角膜组织生理病理动态变化，本文通过对LASIK术后远期角膜基质形态学改变的共聚焦显微镜观察，以探求术后远期角膜屈光状态的改变在组织学上的影响因素，客观评价术后长期角膜的状况，从而为进一步改善屈光手术提供客观依据。 1 资料与方法 1.1 一般资料 选择1999年4月17日～2002年7月31日期间在天津医科大学眼科中心屈光手术门诊行LASIK手术的患者68例(68眼)，其