准分子激光角膜原位磨镶术对角膜内皮的影响

目的　探讨准分子激光角膜原位磨镶术(LASIK)对角膜内皮的影响。方法　将行LASIK术患者60例116眼,分为A组38例73眼(未配戴角膜接触镜组),B组22例43眼(戴角膜接触镜组)。两组激光切削深15~150μm,平均激光切削深度 86.23±22.31μm, 术前及术后3个月进行角膜内皮显微镜检查,观察角膜内皮细胞密度、形态。分析切削深度与角膜内皮密度的相关性。结果　①A组术前角膜内皮密度与术后3个月角膜内皮密度无显著性差异(t=0.329,P>0.05)。②B组术后 3个月平均角膜内皮密度明显高于术前,有显著性差异(t=3.859,P<0.01)。术后角膜内皮形态无明显改变。③A组角膜切削深度与角膜内皮细胞密度无显著相关性(r=0.0321,P>0.05)。结论　LASIK术后早期不引起中央部角膜内皮细胞密度和形态改变。

The study of changes of the corneal endothelium after LASIK

Objective To study the changes to the corneal endothelium after LASIK.Methods 116 eyes of 60 patients performed LASIK were divided into two groups: Group A (73eyes, 38patients)did not worn contact lenses before treatment, Group B(43eyes, 22 patients) had worn contact lenses. The mean depth of laser ablation was 86.23±22.31μm, ranging from 15 to 150μm. Density and morphology of corneal endothelial cell were observed by specular microscopy before LASIK and 3 months after operation. The correlation between depth of laser ablation and endothelial cell density was analyzed. Results ①The average cornal endothelial dell density of Group A of pre- LASIK and post- LASIK was 2921.50±286.31/mm2, 2938.1±321.28/mm2, respectively. There was no significant difference (t=0.329, P>0.05). ②However, density increased by 261.20±99.63/mm2 in Group B after surgery compared to preoperative levels, and there was very significant difference (t=3.859,P<0.01). ③There was not significant change in the morphology of the corneal endothelium, and no significant correlations were observed between ablation depth and the mean density of corneal endothelium cells in group A (r=0.0321, P>0.05).Conclusion LASIK doses not induce changes in the density and morphology of the corneal endothelial cells in the early stage after operation.