原发性青光眼患者角膜内皮细胞的改变

Changes of Corneal Endothelium in Patients with Primary Glaucoma

目的 探讨原发性开角型和闭角型青光眼患者的角膜内皮细胞密度及形态的变化。方法 青光眼患者 6 8人 12 5只眼 ,与患者年龄相匹配的正常人 32人 6 3只眼。除外角膜病、眼部炎症、外伤及接受过内眼手术的眼。采用非接触型角膜内皮显微镜观察、测量角膜内皮细胞密度和细胞面积等各项指标 ,用 Goldm an压平式眼压计测量眼压 ;分析比较不同类型青光眼各组角膜内皮细胞各项测量指标的差异。结果 青光眼组角膜内皮细胞密度[(2 386 .81± 2 89.76 ) / m m2 ]比正常对照组 [(2 5 40 .78± 195 .6 6 ) / m m2 ]明显降低 (P<0 .0 1)。其中原发性闭角型青光眼 (PACG)组角膜内皮细胞密度 [(2 2 6 2 .6 5± 338.6 4) / mm2 ]较正常组低 ,且细胞面积等各项指标均增高 (P<0 .0 1)。特别是有急性发作史的 PACG角膜内皮细胞密度 [(192 5 .16± 40 3.38) / mm2 ]明显减低 ,细胞面积等各项指标明显增高 (P<0 .0 1)。但青光眼组中原发性开角型青光眼 (POAG)组和无急性发作史的 PACG组的角膜内皮细胞各项指标与正常组相比 ,差异无显著性意义 (P>0 .0 5 )。未发现角膜内皮细胞密度与眼压间存在相关性。结论 有急性发作史的 PACG,其角膜内皮细胞密度明显低于正常人 ,且细胞面积明显增大。而

Objective To study the density and morphology of corneal endothelium in patients with primary glaucoma Methods 125 eyes of 68 patients with glaucoma were compared with 63 eyes of 32 patients without glaucoma in the same age group Exclusion criteria included history of corneal disease,ocular inflammation,trauma,contact lens wearing and surgery The following date were recorded:type and duration of glaucoma,glaucoma medications,and intraocular pressure(IOP)measurement Non contact specular microscope was performed on the central cornea,endothelial images were analyzed by computer Results Corneal endothelium density was significantly lower in patients with glaucoma[(2386 81±289 76)/mm 2]than that in controls[(2540 78±195 66)/mm 2] Cell density of primary angle closure glaucoma(PACG)[(2262 65±338 64)/mm 2]was significantly low,especially in acute PACG[(1925 16±403 38)/mm 2] The area of endothelium became bigger than normal But the endothelium density and morphology of primary open angle glaucoma(POAG)and non acute PACG had no changes No correlation was found between mean recent IOP and endothelium density Conclusions This study suggested that patients with acute PACG might have lower corneal endothelium density and bigger cell area than those without glaucoma in the same age group The endothelium density and morphology of POAG and non acute PACG were as similar as those of normal persons