眼科激光对角膜内皮的影响

The changes of corneal endothelium after laser therapy

目的观察Nd:YAG激光及532nm激光对角膜内皮细胞的影响。方法用角膜内皮细胞显微镜分别对Nd:YAG激光周边虹膜切除术以及后囊膜切开术的患眼和532nm激光治疗中心性浆液性脉络膜视网膜病变(CSC)及糖尿病性视网膜病变(DR)的患眼进行角膜内皮细胞的观察。结果所有行Nd:YAG激光治疗患者激光术后14d,中央角膜细胞密度(CD)减少,具有统计学意义(P<0.05);激光虹膜切除术后14d,中央部位CD减少,有统计学意义(P<0.05);术后7d,周边爆破处平均细胞面积(AVE)、最小细胞面积(MIN)、CD及六边形细胞百分率(6A)的变化均具有统计学意义(P<0.05);激光治疗后发性白内障后7d及14d中央部位及爆破处角膜内皮细胞的各项检测指标的改变均无统计学意义(P>0.05)。532nm激光光凝治疗CSC、DR后角膜内皮细胞的各项检测指标的改变均无统计学意义(P>0.5)。结论Nd:YAG激光周边虹膜切开术对角膜内皮有一定的损伤。532nm激光治疗CSC及DR对角膜内皮细胞造成的影响没有统计学意义。

Objectives To explore the changes of corneal endotbelium after the Nd：YAG and 532nm laser therapy. Methods Use the corneal cndothelium microscope to observe the corneal endothelium of the eyes which had been subjeered to the treatment of posterior capsular opacification and peripheral iridectomy by using the Nd： YAG laser and to observe the corneal endothelium of the eyes which had been subjected to the treatment by using the 532nm laser. Results Among the entire Nd： YAG laser sufferer, 14 days later, iF the center of the corneal eadothelium, the decrease of the cell density revealed statistically significant difference （ P 〈0.05 ）. After the treatment of peripheral iridectomy, 14 days later, in the center of the corneal endothelium, the decrease of the cell density revealed statistically significant difference （ P 〈 0.05）. 7 days later, in the periphery of the corneal endothelium, cell area; minimum cell area, cell density and percentage of hexagonal endothelium were analyzed statistically significant difference （ P 〈 0.05 ）. After the treatment of posterior capsular opacification, there was no significant correlation between pre-and postoperative central and 6 o＇ clock periphery of corneal endothelium in 7 and 14 days （ P 〉0.05 ）. There was no significant correlation between pre-and postoperative central and 6 o＇ clock periphery of corneal endothehum in central serous chomidoretinopathy and diabetic retinopathy treatment （ P 〉 0.05 ）. Conclusion The Nd ： YAG laser peripheral iridectomy will damage to corneal endothelium. The treatment of central serous chomidoretinopathy and diabetic retinopathy by using the 532nm laser will not do the statistically significant damage to the corneal cndothelium.