联合绿激光及Nd:YAG激光周边虹膜切开术后角膜内皮细胞的研究

目的:定性及定量观察联合绿激光及Nd:YAG激光周边虹膜切开术后的角膜内皮,并研究此术式对角膜内皮的影响。方法:对19例36眼闭角型青光眼患者,先用绿激光(半导体泵浦的倍频YAG激光)对虹膜作“蜂巢”状烧灼,然后用Nd:YAG激光切透虹膜。手术前、术后1周及1月分别用接触式角膜内皮镜进行定量定性观察及统计分析,包括角膜内皮细胞、细胞面积、变异系数、六角形细胞百分数。结果:患者均经一次联合激光治疗成功切透虹膜。36眼术前及术后1周、1月角膜内皮细胞密度、平均面积、变异系数、六边形细胞百分数差异均无统计学意义(P>0.05)。结论:联合绿激光及Nd:YAG激光行虹膜周边切开术对角膜内皮细胞无明显损伤,其效果确切且安全。

Changes of corneal endothelium after combined green laser and Nd:YAG laser iridotomy

Objective: To investigate the changes of corneal endothelium after combined green laser and Nd:YAG laser peripheral iridotomy on eyes with angle-closure glaucoma. Methods: For 19 cases(36 eyes)of angle-closure glaucoma,green laser (frequency-doubled YAG laser) was used to create a photocoagulation area on the iris, then Nd:YAG laser completed perforation in the iris. By specular microscope before and 1 week, 1 month after laser iridotomy, cell density, cell area, cell variation and percentage of hexagonal endothelium of corneal endothelium were observed and analyzed statistically. Rusults: All patients obtained a patent iris perforation after being treated once with combined laser. No significant differences were found in above indexes between preoperative and postoperative corneal endothelium(P>0.05). Conculsion: Combined green laser and Nd:YAG laser iridotomy has no apparent damage to corneal endothelium and is a safe and efficient treatment modality.