激光共焦显微镜观察超声乳化白内障吸出术后角膜的组织学改变

Histological changes in the cornea under Laser confocal microscope after phacoemulsification

目的:利用激光共聚焦显微镜评价超声乳化白内障摘除术后角膜的活体组织学改变。方法:随机选择中国医科大学眼科医院30例欲行白内障摘除手术的患者进行超声乳化白内障摘除术。患者于手术前、术后1,7,30d;6mo,利用海德堡Retina Tomograph III-Rostock Cornea Module(HRT-IIIRCM)激光共聚焦显微镜对角膜各层细胞及神经进行形态学分析。结果:形态学观察发现角膜上皮细胞和前基质细胞在术后无明显改变。角膜基质神经纤维呈不规则的节段状改变,在术后第7d最为显著。中基质及后基质层的角膜细胞同术前相比反射更为明显。角膜内皮细胞的细胞核和细胞质肿胀。结论:超声乳化白内障摘除手术对角膜组织有一定的影响,导致细胞和组织形态的改变,但这些改变是可逆的。

AIM：To define the microscopic cornea changes with in vivo laser scanning confocal microscopy after phacoemul-sification. METHODS： Thirty eyes were assigned to undergo cataract extraction by ultrasonic phacoemulsification in China Medical University. The morphologies of corneal layer by layer were evaluated in vivo with the Heidelberg Retina Tomograph III-Rostock Cornea Module （HRT-III RCM） confocal microscope pre- and post-operation for up to six months. RESULTS： For morphology, some irregular segments of nerve fiber were most pronounced seven days post-operation. Stroma keratocytes were obvious compared with the pre-operative condition. Corneal endothelial cells become obviously swollen in both the cytoplasm and nucleus. At six months, corneal cell and nerve morphology recovered to normal. CONCLUSION： Microstructural abnormalities were identified at each level of the cornea recovery process after phacoemulsification and lead to corneal morphology changes, but these could be recovered to normal in six months.