正常人角膜内皮细胞的增龄性变化

目的了解正常人角膜内皮细胞的增龄性改变。方法采用日本Topcon角膜内皮计,对180例（343只眼）6～94岁不同年龄正常人角膜进行5个方位检查,分析不同年龄个体角膜内皮细胞密度、平均面积、标准偏差和面积变异系数、六角形细胞所占比例以及中央角膜厚度等结构参数的状况。结果受检者平均年龄（40.77±22.02）岁（6～94岁）,平均角膜内皮细胞数目为（128.08±17.24）个,平均密度为（2894.64±372.42）个/mm2,平均六角形细胞所占比例为（55.40±7.90）%,上述3个参数随年龄增长而下降,尤以30岁以后变化更明显。平均角膜内皮细胞面积、平均变异系数及细胞面积标准偏差分别为（353.27±52.56）μm2、（36.25±6.74）%和（128.48±32.46）μm2,呈现随年龄增长而数值增大的趋势;平均角膜厚度为（0.55±0.03）mm,各年龄组间无显著性差异。结论正常人角膜内皮细胞密度和形态随年龄变化而改变,总体呈现随着年龄的增长角膜内皮细胞数目和密度降低、细胞面积增大、变异系数增大、六角形细胞比例减少的趋势。     

正常人角膜内皮细胞形态学研究

本文对９０名正常人角膜内皮细胞形态学进行了研究。观测结果表明，随年龄增长，角膜内皮细胞密度、六边形细胞所占百分数（Ｈ％）降低；而细胞面积、细胞面积变异系数（ＣＶ）增大。以上变化与年龄增长有关，但并非成比例变化。还发现３１—６０岁年龄组（中年）和６１岁以上组（老年）较３０岁以下组有显著差异，但中年和老年组间无明显差异。本文还就本研究结果与其他实验室报告值间的差异进行了初步探讨。     

原发性急性闭角型青光眼和慢性闭角型青光眼角膜内皮细胞的形态学观察

目的观察原发性急性闭角型青光眼和慢性闭角型青光眼角膜内皮细胞的形态学特点及差异。方法应用非接触型角膜内皮细胞计测量眼压基本控制的18例原发性急性闭角型青光眼18只急性发作眼及对侧18只临床前期眼和20例（26只限）中晚期慢性闭角型青光眼中央角膜内皮细胞的单位面积细胞密度（CD），最小细胞面积（MIN），最大细胞面积（MAX），平均细胞面积（AVG），平均细胞面积的标准差（SD）和细胞面积的变异系数（CV），并进行对比分析。结果原发性急性闭角型青光眼急性发作眼组和对侧临床前期限组比较、原发性急性闭角型青光眼急性发作眼组和慢性闭角型青光眼组比较，中央角膜内皮细胞的单位面积细胞密度显著性减少（P〈0．01），最小细胞面积、最大细胞面积、平均细胞面积、平均细胞面积的标准差和细胞面积的变异系数均有显著性增加（P〈0．01）。结论急性增高眼压对角膜内皮细胞造成显著损害，细胞密度明显下降，细胞多形性增加，损害程度与急性增高眼压持续时间有关；急性增高眼压较慢性增高眼压对角膜内皮细胞的损害更大。     

玻璃体视网膜手术后角膜内皮细胞的形态学改变

目的：观察不同术式的玻璃体视网膜手术（vitreoretinal surgery,VRS)后角膜内皮细胞的形态学改变。方法：采用Topcon SP9000型非接触型角膜内皮显微镜对66例66眼行玻璃体视网膜手术前，术后1、3个月角膜内皮细胞的4项形态学定量指标（角膜内皮细胞密度，角膜内皮细胞平均面积、内皮细胞面积变异系数，六角形细胞比率）进行观测，结果：VR术未摘除晶状体组，手术前后角膜内皮4项形态学定量指标相比较，差异均无显著性（P＞0．05），晶状体玻璃体视网膜联合手术（lenticular vitreoretinal surgery,LVRS)组术后角膜内皮细胞密度，六角形细胞比率明显降低，平均细胞面积和变异系数明显增大，与术前相比差异有极显著性（P＜0．001）。结论：LVR术损伤角膜内皮，VR术未摘除晶状体，对角膜内皮无显著影响，为减少手术对角膜内皮的损伤，术前检查角膜内皮，选择合适的手术方式，提高手术技巧，积极控制炎症是十分必要的。     

100例儿童角膜内皮细胞分析

目的：观察４～１０岁儿童中央区角膜内皮细胞密度及形态学特征。方法：应用非接触型角膜内皮显微镜进行观察。结果：儿童中央区角膜内皮细胞平均密度及六角形细胞百分率明显高于成年人（Ｐ＜０．０１），平均细胞面积明显小于成年人（Ｐ＜０．０１）；远视性屈光不正儿童内皮细胞平均密度高于非远视者（０．０１＜Ｐ＜０．０５）。结论：儿童角膜内皮细胞在正常人群中平均密度最高、形态最佳，并具有最大的自身扩潜能力；随着年龄增长，角膜内皮细胞将发生一系列规律性变化。     

Ⅱ型糖尿病患者白内障术后5年角膜内皮细胞的形态学变化

目的观察Ⅱ型糖尿病患者白内障超声乳化手术后5年角膜内皮细胞的形态学变化。设计回顾性病例系列。研究对象选取2008年1月至2008年12月在北京友谊医院行晶状体超声乳化手术的白内障患者71例（87眼）。方法合并Ⅱ型糖尿病的白内障患者38例（44眼）为糖尿病组,单纯老年性白内障患者33例（43眼）作为对照组。所有患者均行白内障超声乳化联合人工晶状体植入术,分别于术前及术后5年采用角膜内皮镜观察角膜内皮数量及形态学的变化。主要指标角膜内皮细胞密度、平均内皮细胞面积、变异系数。结果术前,糖尿病患者与对照组相比内皮细胞密度、平均内皮细胞面积、变异系数均无明显差异（P〉0．05）。糖尿病患者术后5年与术前相比,角膜内皮细胞密度降低,平均内皮细胞面积增加,变异系数增加（P均〈0．01）。对照组患者术后5年与术前相比,变异系数增加（P〈0．01）,角膜内皮细胞密度和平均内皮细胞面积无明显差异（P均〉0．05）。术后5年,糖尿病患者的内皮细胞密度明显低于对照组（P〈0．01）,平均内皮细胞面积明显高于对照组（P〈0．05）,变异系数与对照组无统计学差异（P〉0．05）。结论本小样本的回顾性病例研究显示,与正常人相比,糖尿病患者白内障术后角膜内皮细胞损伤重,修复慢,需要长期随访。     

准分子激光屈光性角膜切削术对角膜内皮细胞的影响

目的 探讨分析准分子激光屈光性角膜切削术（ＰＲＫ）治疗近视后对角膜内皮细胞的影响。方法 对１０１只眼ＰＲＫ术后者,用接触型镜面反光角人皮显微镜（Ｋｏｎａｎ ＳＰ－３５００型,日本）检测不同部位角膜内皮细胞,并统计分析其在不同度数范围内的平均细胞密度、细胞面积的变异系数和六角形细胞的百分率。结果 平均细胞密度在Ｃ组上降１０％,Ａ,Ｂ组的下降无统计学意义。细胞面积的变异系数及六角形细胞百分率均下降１０     

正常人角膜内皮细胞密度及形态化规律探讨

本文采用TOMEYSPEM-1020型角膜内皮细胞分析仪,对233例（384眼）正常人角膜内皮细胞密度及形态的变化规律进行统计分析。角膜内皮细胞密度随年龄增长而降低,角膜内皮细胞平均面积随年龄增长而变大。30岁以前角膜内皮细胞六边型细胞较多,随年龄增长变化较大,细胞大小变异系数较小;30岁以后六边型细胞相对较少,随年龄增长变化较小,细胞大小变异系数较大。     

正常人角膜内皮细胞影象分析

使用日本Ｋｏｎａｎ ＳＰ５０００型接触式角膜内皮及角膜分析仪，观察，分析我国正常人角内皮细胞照片１４４张，结果表明：正常人角膜内皮细胞随年龄增长而趋向衰老的变化，显示了角膜内皮具有自我调整，功能代偿的本能，提出判定角膜内皮“愈合储备”功能标准应根据细胞密度和形态构型而定。     

准分子激光角膜原位磨镶术后角膜内皮细胞的观察

目的 活体观察准分子激光角膜原位磨镶术（ＬＡＳＩＫ）治疗近视后角膜内皮细胞密度和形态学的变化。方法 对９２例（１７６眼）接受ＬＡＳＩＫ矫治了－２．４０～－２５．００Ｄ的近视患者，分别于术前、术后用角膜内皮镜检查角膜中央区皮细胞，并对资料进行分析，又对其中２９例（５４眼）术前接触镜配戴者单独立组分析。结果 ＬＡＳＩＫ治疗殂膜内皮细胞密度无显著性差异（Ｐ〉０．０５），术后内皮细胞密度与角膜切削深度无显     

超声乳化白内障吸除术对高龄患者角膜内皮影响的临床研究

探讨超声乳化白内障吸除术对高龄老年患者角膜内皮的影响。方法 :对 80岁以上高龄老年性白内障患者 6 8例 ( 95眼 )分别于超声乳化白内障吸除术前及术后 3个月进行角膜内皮照相并分析其形态定量指标。结果 :与术前相比 ,术后角膜内皮细胞密度、六角形细胞比率减少 ,平均细胞面积、变异系数增大 ,统计学分析均有显著性差异 (P <0 0 5 )。结论 :高龄老年患者角膜内皮对超声乳化白内障吸除术产生的损伤敏感 ,术前应常规作角膜内皮显微镜检查 ,术中应避免对角膜内皮细胞的损伤。     

光电扫描兼计算机作角膜内皮细胞分析

我们引用光电扫描兼微机分析系统作角膜内皮细胞分析,67眼作了角膜内皮细胞密度与平均细胞面积的计算和测量,与常用的方格计数法所得出的结果极为接近,统计学表明两种分析差异无显著性(P>0.05),另外用分析系统分析了戴硬性角膜接触镜组和年龄性别匹配的对照组各30眼,结果显示戴镜组与对照组单位面积的细胞密度及平均细胞面积在统计学上无差异(P>0.05),戴镜组内皮细胞大小形态变异较明显,最大与最小细胞之比异常增大,细胞面积变异系数与六边形细胞的出现率和对照组比较差异均有显著性(P<0.01)。作者认为此分析系统具有自动化程度较高,效率与精确度高及信息处理量大等优点,对角膜内皮细胞大小与形态变异的分析研究有实用价值。     

BSS与LR对角膜内皮影响的评价

目的　评价白内障超声乳化手术中平衡盐溶液 (BSS)和乳酸钠林格液 (LR)对角膜内皮的影响。方法　白内障超声乳化手术 66例分为 2组 ,分别采用BSS和LR灌注液。用接触式角膜内皮镜和超声角膜测厚仪于术前、术后第 1天和 3月进行测量。结果　两组术后角膜内皮细胞密度和六角形细胞百分率降低 ,细胞面积变异系数和细胞平均面积增大。但BSS组的损伤程度小于LR组 (P <0 0 5 )。术后第 1天 ,两组的角膜厚度增加 ,BSS组厚度增加率小于LR组 (P <0 0 5 )。 3月后 ,角膜厚度恢复至术前水平。结论　BSS和LR液均对角膜内皮造成损伤。但BSS组影响小。两者在维持角膜脱水状态上无差异。对于经验丰富的术者 ,LR可以替代BSS。     

Corneal endothelial cells and central corneal thickness in patients with neurofibromatosis type 1

Purpose:The aim of this study was to evaluate the morphological properties of corneal endothelial cells and central corneal thickness (CCT) in patients with neurofibromatosis type 1 (NF1) and to compare them with age-matched healthy controls.Methods:Nineteen NF1 patients and 38 healthy individuals were recruited. All participants underwent complete ophthalmological examination as well as noncontact specular microscopy to measure endothelial cell density (ECD), average cell area (AVG), coefficient of variation of cell area (CV), the percentage of hexagonal cells, and CCT. Eyes with previous ocular trauma, inflammation or surgery, and preexisting corneal and ocular surface diseases were excluded.Results:NF1 patients had higher ECD compared to healthy controls of the same age (2764.2 ± 270.4 versus 2570.4 ± 449.2 cells/mm, respectively), although at a borderline level (P = 0.051). Patients with NF1 presented significantly lower CV and AVG when compared to controls (32.9 ± 4.6 versus 37.8 ± 9.5%, P = 0.011 and 364.9 ± 34.4 versus 406.0 ± 107.4 µm, P = 0.038, respectively). The NF1 group had significantly higher hexagonality in comparison with controls (55.7 ± 6.5 versus 50.5 ± 9.9%, P = 0.025). CCT was similar between the two groups (P = 0.955).Conclusion:Our results show that corneal endothelium has more favorable morphological characteristics in NF1 patients compared to healthy individuals of the same age.     

Corneal endothelial cell morphology in patients undergoing cataract surgery

PURPOSE: To evaluate the effect of age, gender, axial length, and presence of type II diabetes on corneal endothelial cell morphology in patients undergoing cataract surgery. METHODS: The corneal endothelial cell morphology was investigated in 1,819 eyes of 1,394 patients before cataract surgery. The parameters examined include cell density, coefficient of variation of cell area, and percentage of hexagonal cells. The effects of age, gender, axial length, and presence of type II diabetes on these parameters were evaluated. RESULTS: The mean values in endothelial cell density, coefficient of variation of cell area, and percentage of hexagonal cells in all eyes, were 2,543 +/- 254 cells/mm2 (range, 1906-3,252), 0.64 +/- 0.10 (range, 0.34-1.00), and 37.9 +/- 7.1% (range, 17.6-61.7), respectively. Stepwise multiple regression analysis revealed that age was the only explanatory variable to be relevant to corneal endothelial cell density (R = -0.201, p < 0.0001), coefficient of variation of cell area (R = 0.066, p = 0.0046), and percentage of hexagonal cells (R = -0.086, p = 0.0002). The other variables, including gender, axial length, and presence of type II diabetes mellitus, were found to be irrelevant to any of the parameters of corneal endothelial cells. CONCLUSIONS: Age is the major relevant factor in corneal endothelial cell morphology in patients before cataract surgery.     

日戴与周戴软性接触镜近视患者角膜内皮细胞观察

目的观察日戴与周戴软性接触镜对角膜内皮细胞的影响，探讨戴镜安全性。方法应用非接触式角膜内皮显微镜观察日戴与周戴软性接触镜患者25人47眼及正常对照组24人48只眼的角膜内皮细胞。结果周戴软性接触镜组角膜内皮面积增大、细胞密度减少、六边形细胞百分率下降、变异系数增高；日戴软性接触镜组六边形细胞百分率下降、细胞变异系数增高。结论周戴软件接触镜对角膜内皮细胞密度和形态影响非常显著，日戴软性接触镜仅表现为角膜内皮形态异常。日戴软性接触镜比周戴软性接触镜安全。     

Corneal endothelial cell density and morphology in normal Indian eyes

PURPOSE: To describe corneal endothelial cell density and morphology in the Indian population and to compare endothelial cell characteristics in the Indian population with data available in literature for American and Japanese populations. METHODS: Specular microscopy and corneal pachymetry were performed in both eyes of 537 normal Indian volunteers, aged 20-87 years. Parameters studied included endothelial cell density, cell area, coefficient of variation (CV) in cell area and hexagonality. RESULTS: Mean endothelial cell density in the study population was 2,525 +/- 337 cells/mm2. There was a statistically significant decrease in endothelial cell density with age (p < 0.001, correlation -0.387) and the rate of cell loss was 0.3% per year. There was also a statistically significant increase in mean cell area (p < 0.001, correlation 0.362) and CV (p = 0.02, correlation 0.096), and decrease in percentage of hexagonal cells (p = 0.01, correlation -0.127) with increasing age. There was no significant difference in these parameters between fellow eyes of subjects. In all age groups, the mean endothelial cell density was significantly lower than values reported previously in the Japanese population. The values were less than those described in the American population, but the differences were statistically significant only in the 20-30 and 41-50 year age groups. CONCLUSION: Normative data for the endothelium in the Indian population are reported. Endothelial cell density in Indian eyes is less than the values described in the Japanese and American populations.     

Corneal changes in type II diabetes mellitus in Malaysia

AIM: To compare corneal endothelial structure and central corneal thickness (CCT) between type II diabetics and non-diabetic control patients. To look for correlations between diabetic status and corneal findings. METHODS: Hospital-based, observational study. 200 eyes (from 100 type II diabetic patients and 100 controls) were included. Specular microscopy and pachymetry were used to measure endothelial cell density, size, coefficient of variation in cell area, hexagonality as well as corneal thickness. Independent t-tests were used to compare variables between diabetics and controls. Pearson correlation tests were used to evaluate correlations between corneal findings and diabetic status such as duration of diabetes, haemoglobin A1c (HbA1c) level and severity of diabetic retinopathy. RESULTS: Endothelial cell density in the diabetic group (2541.6±516.4 cells/mm2) was significantly lower than that in the control group (2660.1±515.5 cells/mm2, P <0.05). The average size of endothelial cells, standard deviation (SD) of cell size and coefficient of variation (CV) of cell area were all significantly higher in diabetics. Hexagonality was significantly lower in diabetics (41.1%±19.6%) compared to non- diabetics (45.2%±20.6%). CCT was higher in diabetics but not significant (P >0.05). Duration of diabetes, HbA1c level and severity of diabetic retinopathy were not significantly correlated with corneal endothelial findings. CONCLUSION: Type II diabetes causes a significant alteration in the state of the cornea including reduction in endothelial cell density and increased pleomorphism and polymegathism. Central corneal thickness is unaffected.     

非接触型角膜内皮显微镜对角膜内皮的观察

目的观察正常人及白内障手术患者角膜内皮细胞。方法应用非接触型角膜内皮显微镜作内皮摄像观察。结果正常人角膜内皮细胞是随年龄增长而发生有规律的改变；白内障手术后周边角膜（切口附近）内皮丢失率大于中央区。结论非接触法检查具有便捷、无痛、非创伤性的特点，并适合内眼术后早期观察，是研究角膜内皮的理想工具。