不同角膜接触镜对角膜内皮细胞形态的影响研究

Effects of different corneal contact lens on the morphous of corneal endothelial cells

目的探讨不同角膜接触镜对角膜内皮细胞形态的影响。方法选择2017年2月至2018年5月在眼科就诊的近视患者89例(177只眼),根据佩戴角膜接触镜的的不同分为观察组50例和对照组39例。观察组佩戴软性接触镜,对照组佩戴硬性接触镜,持续6个月,观察角膜内皮细胞形态变化情况。结果2组治疗前后的眼轴长度和角膜散光度差异无统计学意义(P>0.05)。2组治疗后角膜内皮的细胞密度显著低于治疗前(P<0.05),且观察组高于对照组(P<0.05);2组治疗前后变异系数差异无统计学意义(P>0.05)。观察组治疗前后的角膜厚度与diff值差异无统计学意义(P>0.05),对照组治疗后的角膜厚度显著低于治疗前(P<0.05),与观察组比较差异有统计学意义(P<0.05)。观察组治疗期间的高眼压、角膜水肿、眼底出血等并发症发生率为4.0%显著低于对照组的17.9%,差异有统计学意义(P<0.05)。结论相对于硬性角膜接触镜,佩戴软性角膜接触镜在近视患者中的应用能减少对于角膜内皮细胞形态的影响,促进恢复角膜内皮细胞数量与角膜厚度,减少并发症的发生。

Objective To investigate the effects of different corneal contact lens on the morphous of corneal endothelial cells.Methods A total of 89 patients with myopia(177 eyes)were enrolled in the study,who were divided into observation group(n=50)and control group(n=39)accorded to the different types of contact lenses.The patients in observation group were wearing soft contact lens(SCL),however,the patients in control group were wearing hard contact lens(HCL)for 6 months.The changes of morphous of corneal endothelial cells were observed and compared between the two groups.Results There were no significant differences in axial length and corneal astigmatism compared before and after treatment between the two groups(P>0.05).The cell density of corneal endothelium after treatment in both groups was significantly lower than that before treatment(P<0.05),moreover,which in observation group was significantly lower than that in control group(P<0.05).There were no significant difference in the coefficient of variation before and after treatment between the two groups(P>0.05).There were no significant difference in corneal thickness and diff value in observation group before and after treatment(P>0.05).The corneal thickness after treatment in control group was significantly lower than that before treatment(P<0.05),there was a significant difference between the two groups(P<0.05).Moreover the incidence rate of complications including high intraocular pressure,corneal edema and fundus hemorrhage in observation group was 4.0%,which was significantly lower than that(17.9%)in control group(P<0.05).Conclusion As compared with HCL,the application of SCL for patients with myopia can relieve its efffects on the morphous of corneal endothelial cells,promote the recovery of corneal endothelial cell number and corneal thickness,and reduce the occurrence of complications.