裂隙灯显微镜对角膜内皮细胞形态观察的应用

Slit lamp microscope for corneal endothelial cell morphology evaluation

目的探讨裂隙灯显微镜镜面反光照射法对角膜内皮细胞形态观察的应用,以期指导临床诊断与治疗。方法选择2013年1月至6月就诊于我院,经非接触式角膜内皮细胞计数仪检查发现内皮细胞形态变异,数量减少至700个/mm2以下的患者10例和角膜内皮细胞数量及形态正常的健康者12例,对比裂隙灯显微镜镜面反光照射法与内皮细胞计数仪内皮照相两种方法观察内皮细胞形态的效果。结果所有患者利用裂隙灯显微镜(40倍)的镜面反光照射法均可拍摄到清晰的角膜内皮细胞。内皮细胞数量减少的患者,由于内皮细胞数量减少,直径变大,并可见融合变形细胞;对照角膜内皮计数仪检查可见细胞融合增大。同样用裂隙灯显微镜镜面反光照射方法观察正常人角膜内皮细胞,隐约可见细小六边形内皮细胞,内皮细胞数量越多,边界越难以清晰辨别。对照角膜内皮细胞计数仪可以得到同样的结果。裂隙灯显微镜放大倍数减少到16倍时,内皮细胞数量小于700个/mm2者仍可以观察到内皮细胞,但正常人的内皮细胞则无法分辨。结论利用裂隙灯显微镜镜面反光照射法对角膜内皮细胞形态及密度进行观察,是一种有效而快捷的临床技术。

Objective To study the application of slit lamp microscope in evaluation of the cornea endothelial cell morphology , in order to guide clinical diagnosis and treatment .Methods We chose 10 patients who showed endothelial cell morphological variation and decreased number （〈700/mm2 ） under non-contact corneal endothelial cell count instru-ment examination , and 12 patients with normal count and morphology of corneal endothelial cells at Shandong Eye Hospital from January to June 2013.Results With slit lamp microscope （40x） mirror reflective irradiation, corneal endothelial cells can be visualized in all patients .In patients with decrease number of endothelial cells , those cells have larger diameter and visible deformation and fusion;this is consistent with the results of endothelial counter .In contrast, small hexagonal endothelial cells were visible in normal subjects under slit lamp microscope , and cell boundaries were hard to identified when cell count is large .When slit lamp microscope magnification reduced to 16x, the endothelial cells still can be ob-served in the patients whose endothelial cells＆#39;number were less than 700/mm2, but not in normal subjects .Conclusion The use of a slit lamp microscope mirror reflective irradiation to observe the corneal endothelial cell morphology and density is an effective and efficient clinical technique .