高能量快速角膜交联术对角膜内皮细胞的影响

The influence of high energy accelerated corneal collagen cross-linking on corneal endothelial cells

目的观察高能量快速角膜交联术对角膜内皮细胞的影响。方法前瞻性病例研究。收集济南明水眼科医院2018年1月至2019年2月的圆锥角膜76例(76眼)行高能量快速角膜交联术,术中总能量7.2 J/cm2,观察比较术前、术后1周、1个月及6个月角膜内皮细胞密度(CD)、角膜内皮细胞面积的变异系数(CV)及六边形角膜内皮细胞比率(6A)。结果术前CD,CV及6A分别为(2856.71±276.13)个/mm2,30.93±7.65及(57.78±16.52)%。术后1周CD为(2724.94±317.33)个/mm2,与术前比较差异有统计学意义(P=0.007),但是术后1个月、6个月的CD与术前比较差异无统计学意义(均P>0.05)。术后1周、1个月及6个月的CV、6A与术前比较差异均无统计学意义(P>0.05)。结论高能量快速角膜交联术治疗圆锥角膜耗时短,且对角膜内皮细胞影响小。

Objective To observe the influence of high energy accelerated corneal collagen cross-linking on corneal endothelial cells.Methods This was a prospective case study.Total of 76 eyes of 76 patients with keratoconus underwent high energy accelerated corneal collagen cross-linking from Jan.2018 to Feb.2019 in Jinan Mingshui Eye Hospital.Total energy during the surgery was 7.2 J/cm2.Corneal endothelial cell density(CD),coefficient of variation(CV)of corneal endothelial cell area and hexagonal corneal endothelial cell ratio(6A)were examined and compared before operation,1 week,1 and 6 months after operation.Results The preoperative CD,CV and 6A were(2856.71±276.13)cells/mm2,30.93±7.65 and(57.78±16.52)%,respectively.The CD were(2724.94±317.33)cells/mm2 at 1 week after operation,the difference was statistically significant compared with that preoperatively(P=0.007).But there was no significant difference between the preoperation and 1,6 months postoperatively(all P>0.05).There was no significant difference in CV and 6A between the preoperative and 1 week,1 month,6 months postoperatively(P>0.05).Conclusion High energy accelerated corneal cross-linking is safe on corneal endothelial cells for keratoconus,with short time consuming.