LASIK矫治儿童远视性屈光参差性弱视术后角膜内皮细胞的变化

Changes of corneal endothelium after LASIK in treatment for children with hyperopic anisometropic amblyopia

对准分子激光原位角膜磨镶术(excimer laser in situ keratomileusis,LASIK)矫治儿童远视性屈光参差术后的角膜内皮细胞各项指标的变化趋势进行研究,从角膜内皮结构层面探讨LASIK对儿童的安全性。采用回顾性研究方法观察2005~2010年接受LASIK手术矫治且严格按复查时间随访36个月以上的远视性屈光参差性弱视儿童病例47例。通过对手术眼(A组)及非手术眼(B组)进行自身对照的方法,观察术前、术后6、12、24、36个月中央角膜内皮的细胞密度(ECD)、六角型细胞百分比(6A%)、内皮细胞变异系数(CV)和内皮平均细胞面积(AVG)的变化。A、B组ECD在术后各期与术前比较呈下降趋势,术后24、36个月时与术前比较差异有统计学意义(P<0.05);A与B组在各个时期比较无统计学差异(P>0.05)。A、B组的6A%在术后各期较术前均减少,但直到术后36个月时与术前比较差异才有统计学差异(P<0.01)。CV在各个时间段与术前比较呈上升趋势,但差异无统计学意义(P>0.05)。在AVG方面,A、B组在术后24、36个月时与术前比较均明显增加,差异有统计学意义(P<0.05和P<0.01),组间比较无统计学差异(P>0.05)。LASIK不影响儿童角膜内皮细胞在生长发育中的正常变化趋势,同时也证实了LASIK矫治儿童远视性屈光参差性弱视在角膜内皮结构方面的安全性。

A retrospectively study on the changes of corneal endothelium of children hyperopic anisometropic amblyopia by excimer laser in situ keratomileusis( LASIK) was performed in order to explore the safety for LASIK in children's corneal endothelium. 47 cases of children,diagnosis of hyperopic anisometropic amblyopia,who have been performed monocular-LASIK with more than 36 months follow-up were retrospectively studied.To compare the the central corneal endotheliumcell density( ECD),the percentage of six angle type cells( 6A%),coefficient of variation( CV)of endothelium and endotheliumaverage cell area( AVG) changes between preoperation with postoperative 6,12,24,36 months,the operation eye( group A) and non operation eyes( group B) withself control methodwere analyzed retrospectively.ECD of group A and B werebothsignificant decreased thanpreoperative( P < 0. 05) on postoperative 24 and 36 months.Nevertheless,ECD of group has no significant difference with group at all follow-up time( P > 0. 05). 6A% of group A and B at 36 month follow-up wassignificant decreased than preoperative stage( P<0. 01).CV at all follow-up time showed a rising trend compared withpreoperative stage,however,there was no significant differences( P > 0. 05).AVG of group A and B at postoperative 24,36 monthswereboth significantly increased thanpreoperative stage( P<0. 05 and P<0. 01),but there was no significant differences compare group A and Bat all follow-up time( P>0. 05).LASIK is harmless to corneal endothelium of children's anisometropia amblyopia. This observation confirmed the safety of LASIK on corneal endotheliumcell.