中老年高度近视患者中央角膜厚度和角膜内皮细胞的测定

Measurement of central corneal thickness and corneal endothelium in the middle-aged and old patients with high myopia

目的:应用非接触式自动角膜内皮计定量分析中老年高度近视眼患者中央角膜厚度和内皮细胞形态。方法:对56例(64眼)高度近视眼患者及65例(77眼)对照组患者按年龄分为≤60岁和>60岁两组,高度近视组再按眼轴长度分为≤29mm和>29mm两组,应用SPSS11.0统计分析软件对各组角膜内皮细胞的平均面积(AVE)、平均密度(CD)、变异系数(CV)、六角型细胞比率(6A)及中央角膜厚度(CCT)进行独立样本t检验,并将内皮细胞各参数与组内中央角膜厚度做pearson检验。结果:高度近视眼患者角膜内皮细胞平均面积增大、密度减低、变异系数增大、六角形细胞比率降低,与正常对照组比较均有显著性差异(P<0.05),眼轴长度≤29mm和>29mm两组间各内皮参数无显著性差异(P>0.05),中央角膜厚度各组间均无显著性差异(P>0.05)。高度近视眼患者角膜内皮细胞面积与其中央角膜厚度成正相关(r=0.340,P<0.01,y=0.64x+46.99),细胞密度与其中央角膜厚度呈负相关(r=-0.338,P<0.01,y=-4.2x+4862.5),细胞变异系数与眼轴呈正相关(r=0.247,P<0.05,y=0.98x+11.84)。对照组内皮细胞各参数与其中央角膜厚度均无相关性。结论:高度近视对中老年角膜内皮细胞各形态参数均产生较大影响,且中央角膜越厚、眼轴越长,可能预示其"愈合储备"能力越差。

AIM： To analyze quantitatively the central corneal thickness and the corneal endothelium of in the middle-aged and old patients of high myopia with non-contact corneal endothelial microscope. METHODS： A total of 64 eyes （56 patients） of high myopia in the middle-aged and old and 77 eyes （65 normal people） were examined and divided into 2 groups according to their ages. High myopia patients were divided into 2 groups according to the axial length. The independent t-test of SPSS11.0 software was used to analyze their average cell area, the average cell density, the coefficient of variation, the percentage of the hexagonal cell and the central corneal thickness. The pearson test was used to analyze the correlation between the corneal parameters and the central corneal thickness. RESULTS： The average cell area and the coefficient of variation of endothelia in high myopia patients increased, while the average cell density and the percentage of the hexagonal cell decreased. There was statistically significant difference between high myopia group and control. There was no statistically significant difference between the axial length ≤29mm group and 〉29mm group in respect of various endothelial parameters. There was no statistically significant difference in the central corneal thickness between groups. The average cell area was positively correlated with the central corneal thickness （r =0.340, P 〈0.01, y= 0.64x＋46.99）, while the average cell density was negatively correlated with the central corneal thickness length （r=-0.338, P 〈0.01, y=-4.2x＋4862.5）. There was positive correlation between the coefficient of variation and the axial （r=0.247, P〈0.05, y=0.98x＋11.84）. There was no correlation between various endothelial parameters and the central corneal thickness in normal group. CONCLUSION： High myopia had great effects on the corneal endothelium morphology in the middle-aged and old. When the central cornea becomes thicker, the axial becomes longer, the repair ability will probably be poorer.