白内障激光乳化术后角膜组织的共焦显微镜观察

The changes in each layer of corneal tissue after phacolaseby confocal microscope in vivo

目的研究人白内障激光乳化手术后角膜各层组织的共焦显微镜下形态学改变。方法应用con—foscan3．0共焦显微镜对Er：YAG激光乳化手术后1周～1月、无严重手术并发症的患者共10例（10只眼），进行扫描检查，记录和分析各层角膜组织图像。结果confoscan3．0能够清楚地显示角膜的上皮细胞、基底层细胞、前弹力层、基质层细胞以及内皮细胞。激光乳化术后稳定的角膜同正常角膜的相应细胞在图像上没有显著差异，但有水肿的角膜在共焦显微镜下各层细胞均有明显改变。结论（1）confoscan3．0共焦显微镜可以活体检查白内障激光乳化术后角膜组织结构和细胞的病理改变；（2）激光乳化作为一种新的白内障手术方式对角膜组织的损伤轻微；（3）活体共焦显微镜可以作为评价白内障手术后角膜组织改变的最佳检查。

Objective The stable aim corneas of the phacolase were in-real time observation and morphological evaluation by confocal 3.0 microscopy. Methods Ten eyes of 10 patients on one week to one month after phacolase were examined by confocal 3.0 microscope in vivo. Images were recorded by continuously focusing the optical section through the full thickness central cornea. Results The epithehum, basal epithelial layer, lamina elastic anterior, stroma layer and endothehal layer were observed obviously in confoscan 3.0. the same as the normal corneal in stable corneal after phacolase, while in the edemal cornea, changes were obviously observed. Conclusions （ 1 ） Confoscan 3.0 is a new tool for the study of cellular morphology and construction of the cornea after phacolase in cataract. （2） Phacolase as a new metihod to treat cataract is safe to the cornea. （ 3 ） Confocal microscope can be the best method to evaluate cellular morphology and construction changes of cornea after cataract surgery.