共焦显微镜评价长期配戴角膜接触镜对眼角膜组织的影响

目的应用共焦显微镜对长期配戴角膜接触镜患眼在不同时期的角膜组织的变化进行观察和分析。方法选择于大连医科大学附属一院眼科门诊进行检查的戴角膜接触镜患者47例（93眼1，年龄为17-38岁，屈光度为-1．75- 10．00D．平均日戴时间超过8h，戴镜时间为1～18年。分为三组：第一组（G1），戴镜时间5年以内者（含5年）；第二组（G2），戴镜时间5～10年者（含10年）；第三组（G3），戴镜时间10年以上者。另选择未戴角膜接触镜者15例（30眼）为第四组（G4），年龄为18～40岁，屈光度为-0．75～8．00D。共焦显微镜记录各层角膜图像,并对各层组织细胞形态、细胞密度等进行自动分析。四组间统计学分析采用单因素方差分析。结果①四组的角膜中央区Langerhans细胞密度分别为：（206．0±21．7）个/μm^2、（229．0±28．0）个／μm^2、（251．0±50．8）个／μm^2（154．0±36．7）个／μm^2。四组的角膜缘Langerhans细胞密度分别为：（308．0±76．4）个／μm^2、（364．0±53．9）个／μm^2．（417．0±83．6）个／μm^2、（254．0±127．0）个／μm^2。四组之间差异有统计学意义（P〈0．05）。②四组的角膜上皮厚度分别为：（51．2±4．5）μm、（45．6±2．7）μm、（43．5±5．0）μm、（53．6±2．5）μm。四组的前基质角膜细胞密度分别为：（1157．0±120．5）个／μm^2、（1094．0±103．0）个／μm^2、（1011．0±197．8）个／μm^2、（1187．0±139．0）个／μm^2。四组之间差异有统计学意义（P〈0．05）③四组的多形性内皮细胞百分比分别为：（36．2±1．7）％、（33．7±1．7）％、（32．8±1．5）％、（45．1±9．1）％四组的内皮细胞异形性百分比分别为：（56．5±3.4）％、（63．3±3．7）％、（64．2±7．11％、（45．8±12．2）％四组之间差异有统计学意义（P〈0．05）④四组的角膜全层厚度、后?

Evaluation of corneal changes from longterm contact lens wear using a confocal microscope for analysis

Objective To analyze corneal changes from long-term contact lens （CL） wear using a confocal microscope. Methods Forty-seven patients ranging from 17 to 38 years of age, with a history of long-term contact lens wear ranging from 1 to 18 years, were selected for the study. The average time for CL wear was more than 8 hours daily. Refractive error was -1.75- -10.00 D. Three distinct time-based subject groups were involved： those who had worn CLs for less than 5 years （including 5 years, G1）, those who had worn CLs from 5 to 10 years （including 10 years, G2）, and those who had worn CLs for more than 10 years （G3）. Fifteen myopia subjects, ranging from 18 to 40 years of age with no history of contact lens wear were included in the study as G4. Refractive error was -0.75- -8.00 D. A confoeal microscope was used to examine all patients. The images were recorded and cell morphology and densities were automatically measured with the microscope. Results were analyzed by using a one-way ANOVA. Results The following measurements were obtained for the four respective subject groups （G1, G2, G3 and G4）： ①The densities of Langerhans cells in the central cornea were （206.0±21.7）cells/μm^2, （229.0±28.0）cells/μm^2, （251.0±50.8 ）cells/μm^2, and （154.0±36.7 ）cells/μm^2 and the densities of Langerhans cells in the limbal cornea were （308.0±76.4） cells/μm^2, （364.0±53.9）cells/μm^2, （417.0±83.6）cells/μm^2, and （254.0±127.0）cells/μm^2. There were significant differences among the four groups （P〈0.05）.②The epithelial thicknesses were （51.2±4.5）μm, （45.6±2.7）μm, （43.5±5.0）μm, and （53.6±2.5）μm and the densities of anterior stromal keratocytes were （1157.0±120.5 ）cells/μm^2,（1094.0±103.0）cells/μm^2, （1011.0±197.8 ） cells/μm^2, and （1187.0±139.0）cells/μm^2. There were significant differences among the four groups （P〈0.05）. ③The percentages of endothelial polymorphology were （36.2±1.7）%, （33.7±1.7?