干眼对角膜内皮细胞的影响及相关因素分析

Impact of dry eye on corneal endothelial cell density and morphology

目的对干眼患者及健康人进行对照研究,评估干眼对角膜内皮细胞的影响及分析相关因素。方法收集2017年6月至2018年1月眼科门诊收治的156例患者,分为干眼组和对照组,进行裸眼视力、非接触眼压、裂隙灯检查、泪液分泌试验、泪膜破裂时间、角膜荧光素染色评分、主观症状及眼表疾病指数评分(OSDI)筛查,并对角膜内皮细胞密度(ECD)、角膜内皮细胞平均面积(ACA)、角膜内皮细胞变异系数及六边形细胞比例进行研究。结果干眼组与健康组相比,其ECD较少,ACA较大。干眼组年龄、干眼病程、OSDI指数与ECD呈负相关,与ACA呈正相关,年龄及OSDI指数与内皮细胞变异系数呈正相关,且女性六边形细胞比例较男性低。结论干眼对角膜内皮细胞的形态结构及数量均有损害。

Objective To evaluate the impact of dry eye on corneal endothelial cell density and morphology and explore the influencing factors involved.Method 156 patients were recruited from the ophthalmology department of our hospital between June 2017 and January 2018 and were divided into two groups,a dry eye group and a control group,on the basis of their history and examination results.Examinations included uncorrected visual acuity,slit lamp examination,non-contact intraocular pressure,tear break-up time,Schirmer I test（without anesthesia）,corneal fluoresce staining,and non-contact specular microscope for evaluating the corneal endothelia.Meanwhile,the patients＇ onset time of dry eye symptoms and ocular surface disease index（OSDI） were also collected.Results Compared with the control group,the endothelial cell density（ECD） was statistically lower,and the average cell area（ACA） was statistically larger.Age,duration of dry eye symptoms,and OSDI were negatively correlated with ECD,and were positively correlated with ACA.Age and OSDI were positively correlated with a coefficient of variation.Moreover,the hexagonality of corneal endothelial cells in females was statistically lower than in males.Conclusion Corneal endothelial cells in the dry eye patients had reduced density and damaged morphology.