急性闭角型青光眼大发作对角膜内皮细胞的影响

Effects of acute angle-closure glaucoma attack on corneal endothelial cell

目的观察急性闭角型青光眼大发作后患者角膜内皮细胞的形态和数量的变化。方法采用非接触型角膜内皮显微镜对33例单眼发病的急性闭角型青光眼患者,以对侧眼为对照,测量角膜内皮各参数。结果急性闭角型青光眼急性发作组和对照眼比较,角膜内皮细胞密度(CD)、六角形细胞百分数(6A)显著性减少(P<0.05),最大细胞面积(MAX)、最小细胞面积(MIN)、平均细胞面积(AVE)、平均细胞面积的标准差(SD)和细胞面积的变异系数(CV)均有显著性增加(P<0.05)。Spearman相关性分析,角膜内皮细胞密度下降幅度与高眼压持续时间呈正相关(r=0.525,P=0.002)。结论急性闭角型青光眼大发作会引起角膜内皮细胞密度下降,体积增大,多形性增加,高眼压持续时间越长,对角膜内皮细胞的损害越严重。

Objective To observe the morphological and quantitative changes of corneal endothelial cells in patients after an acute attack of angle-closure glaucoma. Methods 33 patients with unilateral acute angle closure glaucoma were enrolled. Fellow eyes were used as control. Using non-contact specular microscopy endothelial cell parameters were measured. Results Mean corneal endothelial cell density（ CD） and percentage of hexagonal cells（6 A） significantly decreased in affected eyes. Mean maximal cell area（ MAX）,minimum cell area（ MIN）,average cell area（ AVE）,cell area standard deviation（ SD） and cell area coefficient of variation（ CV） significantly increased. Spearman correlation analysis suggested that the decrease in corneal endothelial cell density is positively correlated with the duration of high intraocular pressure（ r = 0. 525,P = 0. 002）. Conclusions Acute angle-closure glaucoma result in significant decrease of corneal endothelial cell density,and significant increase of cell area increase and pleomorphism. The longer the high intraocular pressure the more damages to the corneal endothelial cells.