小梁切除术对角膜内皮细胞影响的研究

Morphological study of corneal endothelium in trabeculectomy

目的探讨小梁切除术对角膜内皮细胞的影响。方法对29例(37眼)青光眼行小梁切除术。分别于术前和术后3月内进行角膜内皮照相并分析其形态和定量指标。结果角膜内皮细胞密度、平均细胞面积、六角形细胞所占比例及变异系数4种指标术前术后差异无统计学意义(P>0·05)。小梁切除术后正常前房和Ⅰ、Ⅱ度浅前房者,术前术后中央角膜内皮细胞密度差异无统计学意义(P>0·05)。Ⅲ度浅前房中央内皮细胞丢失率为69·11%。结论正常过程小梁切除术对角膜内皮细胞影响不显著,小梁切除术后浅前房是角膜内皮细胞丢失的主要因素,尤其是Ⅲ度浅前房。

Objective To explore the morphological Changes of corneal endothelium in trabeculectomy. Methods 29 cases（37 eyes） of glaucoma received trabeculectomy. The endothelium cell density, average cell area, percentage of hexagonal cell density and cell size variation coefficient were determined with non - contact specular micrnscopy preoperatively and 3 months postoperatively. The endothelial images were analyzed by computer. Results The endothelium cell density, percentage of hexagonal cell density, average cell area and cell size variation coefficient were no significant differences between the preoperative and postoperative morphotogic indexes （ P 〉 0. 05 ）. The endothelium cell density were no significant statistical difference between the preoperative and postoperative in the normal anterior chamber group, one degree of shallow anterior chamber group and 2 degree of shallow anterior chamber group （ P 〉 0.05 ）. Cell loss rate was 69.11% at center of cornea in 3degree shallow case. Conclusions There were no significant injury of corneal endothelium in normal trabeculectomy. The major cause of injury of corneal endothelium was shallow anterior chambers after trabeculectomy, especially three degree shallow anterior chamber.