应用共聚焦显微镜对中央角膜组织与屈光度相关性的初步研究

目的 应用共焦显微镜对活体正常角膜各层组织与屈光度之间的相关性进行观察和分析.方法 选择门诊进行屈光检查的患者107例(107只眼).所有患者均经散瞳检影验光检查進行确诊,且矫正视力为0.8以上(屈光度≥-0.75D),检查各层角膜图像均被记录,并对各层细胞形态、细胞密度、角膜全厚、基质厚度、上皮厚度等进行分析.结果上皮基底細胞密度与等效球镜度数呈负性相关性.前基质角膜细胞密度与等效球镜度屈光度呈正相关性.后基质角膜细胞密度与等效球镜度屈光度呈正相关性.内皮细胞密度与等效球镜度呈负性相关性.内皮细胞的多型性与等效球镜度正相关性. 内皮细胞的异型性与等效球镜度无相关性.上皮厚度与等效球镜度数之间无相关性.角膜全厚、基质厚度与等效球镜度数呈负性相关.结论 随着屈光度增加,角膜上皮基底膜细胞、角膜基质细胞、角膜内皮细胞数量下降,角膜全层、角膜基质厚度减少.

The study of the relationship between the central cornea with the manifest spherical equivalent(MSE)in adults by in vivo confocal microscopy

Objective To investigate the influence of age on central corneal tissues and to characterize more precisely the anatomy of the cornea by in vivo confocal microscopy.Methods One hundred and eight-four eyes of 184 normal subjects ranging between 18 and 80 years old who diagnosed emmetropia in Eye center of Tianjin Medical University from 2003.8～2007.12 and all eyes were examined in vivo by confocal microscopy,the images were recorded,cell morphology,densities and thickness were measured for study and analysis.Results We found the densities of superficial basement epithelial cells has a significant negative correlation with the manifest spherical equivalent(Spearman rank correlation,r =-0.355 P=0.017)and the keratocyte density of the anterior stroma has a significant positive correlation with the manifest spherical equivalent(Spearman rank correlation,r 1=0.0284 P=0.018<0.05)and the posterior stroma has a significant negative correlation with the manifest spherical equivalent;(r =-0.355 P=0.007<0.05).The thickness of epithelium has no correlation with the manifest spherical equivalent(Spearman rank correlation,r =0.094 P=0.125>0.05).The mean of the total corneal thickness and stroma thickness has a significant negative correlation with the manifest spherical equivalent(Spearman rank correlation,r 1=-0.4497 P=0.000,r 2=-0.453 P=0.000<0.05).We found the endothelium density has a significant negative correlation with the manifest spherical equivalent(Spearman rank correlation,r =-0.407 P=0.000<0.05)and the percentage of polymorphology of endothelium has a significant positive correlation with the manifest spherical equivalent(Spearman rank correlation,r =0.295 P=0.007)and the percentage of pleomorphism of endothelium has no correlation with the manifest spherical equivalent(Spearman rank correlation,r =0.003 P=0.0.977).Conclusions The changes of the myopic involved in the cornea.Those changes of the eyes included the thinner or thickness of epithelium,thinner thickness of cornea,decreased density of keratocyte and endothelial cells and increased the average size of endothelial cells.Corneal thickness is asymmetric and seems to undergo the manifest spherical equivalent related anatomic changes.This information should be considered when planning penetrating keratoplasty and refractive surgery.