软性角膜接触镜在共焦显微镜下的表现

The study of soft contact lens wearing by the laser confocal microscope in vivo

目的研究软性角膜接触镜在共焦显微镜下的图像特点。方法采用激光角膜共焦显微镜分别观察佩戴的软性角膜接触镜的中央部和周边部，分析研究其图像特点。结果通过角膜激光共焦显微镜检查到了角膜前的角膜接触镜图像，检出率是100％。软性角膜接触镜中央部在共焦显微镜下为波纹状的反光结构，每道波弧由一道中到高反光结构和一道低反光结构构成，弧形排列，逐步扩大，无细胞结构；该波弧以软性角膜接触镜光学部的中心为圆心，一圈一圈逐步扩大，呈同心圆状排列。在白色波弧中央可见点状的暗反光结构，这是软性角膜接触镜的材质在共焦显微镜下的表现。周边部在共焦显微镜下的波弧未成同心圆状排列，波弧排列可以比较紊乱，在共焦显微镜下可以显示波弧从三个或多个不同方向汇集。在佩戴的软性角膜接触镜上发现有杂质附着，检出率是70．6％；软性角膜接触镜上划痕的检出率是47．1％。结论共焦显微镜能直接用高倍数检查佩戴的软性角膜接触镜，使对角膜接触镜的研究进入了活体时代和微米水平，同时为指导临床合理配戴角膜接触镜提供客观依据。在佩戴角膜接触镜时应注意无菌操作，即使肉眼观察到角膜接触镜上没有杂质时，也不能掉以轻心。软性角膜接触镜上的细小划痕对角膜有潜在损伤的作用，提示我们佩戴的角膜接触镜要及时更换，以避免角膜的损伤。

ObJective To study the characteristics of soft contact lens wearing by laser confocal microscopy in vivo. Methods The central and peripheral parts of soft contact lens wearing were examined by laser confocal microscopy respectively. The image features of two parts were studied. Results The central parts of soft contact lens were corrugated reflective structure in laser confocal microscopy. Each wave was composed of a high reflective structure and low reflective structures, ar- ranged in curved and gradually expand, and no cell structure. The central parts of soft contact lens were the center of a circle, around a circle and gradually expand in concentric circles arranged like. The white wave was composed of dark reflective structure, which was the soft contact lens material. The peripheral part of that were unpaired concentric circles arranged like and the arrangement could be relatively disordered. The rate of impurities attaching to the soft contact lens wearing was 70.6%. The rate of scratches on the soft contact lens wearing was 47.1%. Conclusions Confocal microsco- py with high expansion check for soft contact lens wearing, the study of soft contact lens into the era of in vivo and micron level, as well as that to provide an objective basis to guide the rational contact lens wear. Wear contact lens should pay attention to aseptic technique, even if the naked eye contact lens free of impurities, it can not be taken lightly. Small scratches on the soft contact lens on the corneal potential damage prompted us to wear contact lenses should be promptly re- placed to avoid damage to the cornea.