急性闭角型青光眼小梁切除术后角膜内皮形态研究

Morphometric study of the endothelium following trabeculectomy in primary angleclosure glaucoma

为探讨急性原发性闭角型青光眼（ＰＡＣＧ）及其小梁切除术后角膜内皮细胞（ＣＥＣ）的形态计量学变化和临床意义。对３６例ＰＡＣＧ患者于小梁切除术前和术后３个月进行了角膜内皮细胞观察和图象分析。结果：与正常人相比，ＰＡＣＧ患者ＣＥＣ密度、形状系数明显减小，面积、周长、长径、变异系数增大（Ｐ＜０．０１）。无并发症的小梁切除术未使ＣＥＣ发生形态计量学变化。而术后浅前房者与术前相比ＣＥＣ密度和形状系数进一步减小。面积、周长、长径和变异系数进一步增大。结论：ＰＡＣＧ患者ＣＥＣ处于不稳定状态，应尽早控制眼压。

Objective:To study the morphometric changes of the endothelium following trabeculectomy in primary angleclosure glaucoma(PACG)and to evaluate the clinicl significance of these changes.Methods:The corneal endothelial cells(CEC)of 36 patients with PACG were examined by specular microscopy and the morphology of the CEC were analysised by computerasisted image analysis system before and after trabeculectomy.Results:As compared to the normal controls,the CEC of PACG showed a obviously decreased cell density(D),figure coefficient(FC)(P<001)and an increased area(A),perimeter(Pe),long axis(L),coefficient of variation(CV)(P<001)Uncomplicated trabeculectomy didnt produce endothelial morphometric changes.But the patients with shallow anterior chambers postoperatively had a further decreased D,FC and a further increased A,Pe,L and CV.Conclusions:The CEC of PACG are in an unstable condition.The intraocular pressure should be controled as early as possible.As making a plan of trabeculectomy or carring out the operation,the prevention and treatment of shallow anterior chambers are very important for protecting the CEC.