急性闭角型青光眼和慢性闭角型青光眼对角膜内皮细胞的影响分析

目的观察急性闭角型青光眼和慢性闭角型青光眼对角膜内皮细胞的影响。方法采用TOPCON非接触型角膜内皮细胞计,对眼压控制的33例(仅单眼急性发作)原发性急性闭角型青光眼急性发作眼及对侧临床前期眼和23例(33只眼)慢性闭角型青光眼患者,测量角膜内皮细胞变化情况,并进行对比分析。结果急性闭角型青光眼急性发作眼组和对侧临床前期眼组比较,角膜内皮细胞平均密度有极显著性减少(P<0.01),最大细胞面积、最小细胞面积、平均细胞面积、平均细胞面积的标准差和细胞面积的变异系数均有显著性增加,六角形细胞百分数显著性下降(P<0.05);慢性闭角型青光眼组和急性闭角型青光眼对侧临床前期眼组比较,角膜内皮细胞平均密度显著性减少(P<0.05),最大细胞面积、最小细胞面积、平均细胞面积、平均细胞面积的标准差、细胞面积的变异系数均和六角形细胞百分数差异均无统计学意义。结论急性闭角型青光眼对角膜内皮细胞造成细胞平均密度明显下降和细胞的形态改变、六角形细胞百分数下降等显著损害,损伤程度与眼压急性增高的程度和持续时间有关;慢性闭角型青光眼仅造成角膜内皮细胞平均密度明显下降,并未影响细胞的形态改变及六角形细胞百分数。

Objective To observe the effect of acute angle-closure glaucoma and chronic angle-closure glaucoma on corneal endothelium. Methods Using non-contact TOPCON , on intraocular pressure control 33 cases （only monocular acute onset） primary acute angle-closure glaucoma, acute eye and the contralateral eye preclinical and 23 patients （33 eyes） with chronic closed angle glaucoma, measuring changes in corneal endothelium and comparative analysis. Results In Acute angle-closure glaucoma, as compared to the contralateral eye preclinical group, the average density of corneal endothelium which in acute eye group has a very significant reduction （P〈0.01）, the maximum cell size, the smallest cell area, mean cell area, mean cell area standard deviation and coefficient of variation of cell area were significantly increased, the percentage of hexagonal cells was significantly decreased （P〈0.05）;Compared to the acute angle-closure glaucoma eye contralateral preclinical group, the average density of corneal endothelial cells was significantly decreased in Chronic angle-closure glaucoma group （P〈0.05）, the maximum cell size, the smallest cell area, mean cell area, mean cell area standard deviation, coefficient of variation of cell area and percentage of hexagonal cells shows no significant difference. Conclusion Acute angle-closure glaucoma caused cell average density decreased and cell morphological changes, decreased the percentage of hexagonal cells and other significant damage, the grade of the damage depends on the extent and duration which the intraocular pressure increased. Chronic angle-closure glaucoma only caused mean density of corneal endothelium significant reduce, and shows no effect on morphology and percentage of hexagonal cells.