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目的 利用共焦显微镜观察LASIK术后角膜愈合情况。方法 15例 3 0只眼行LASIK术 ,术前、术后 1天、 1周、 1个月和 3个月分别作共焦显微镜检查 ,对角膜基质细胞进行定性和定量分析 ,及对内皮细胞进行定量观察 ,通过Z -scan测量角膜瓣厚度。结果 术后不同时间前基质细胞数量上与术前比较 ,无统计学意义上差异 (F =1 76,P >0 0 5 ) ,早期细胞核形态比术前略显长椭圆形、体大 ,术后 3个月趋于正常 ;后基质细胞无论形态上和还是数量上与术前比较无明显差异 (F =0 7,P >0 0 5 ) ;角膜内皮细胞计数术前、术后 3个月平均分别为 2 781 73± 194 5 6个 /mm2 和 2 685 7±194 5 6个 /mm2 ,二者差异无意义 (t =0 188,P >0 0 5 )。术后 3个月角膜瓣厚度平均为 117 60±13 96μm ,无一例超过 15 0 μm。 结论 共焦显微镜可无创伤、活体上、客观地观察角膜病理情况 ,是观察LASIK术后角膜愈合情况的一种有用的检测手段 ;同时角膜瓣厚度受多种因素影响 ,厂家设定刀头的预定厚度准确性有待进一步提高。
Objective To observe the corneal healing after LASIK by confocal microscope. Methods 15 cases of 30 eyes underwent LASIK surgery, preoperative, postoperative 1 day, 1 week, 1 month and 3 months were confocal microscopy, corneal stromal cells were qualitative and quantitative analysis, and endothelial cells Quantitative observation was performed to measure corneal flap thickness by Z-scan. Results There was no statistically significant difference in the number of stromal cells at different time points after operation (F = 1 76, P 0 05). The morphology of early nucleus was slightly longer than that before operation There was no significant difference in morphology and number of post-stromal cells compared with those before operation (F = 0 7, P> 0.05); corneal endothelial cell counts were preoperative and 3 months after operation With an average of 2 781 73 ± 194 5 6 / mm2 and 2 685 7 ± 194 5 6 / mm2 respectively. There was no significant difference between them (t = 0 188, P 0 05). The thickness of corneal flap was 117 60 ± 13 96 μm at 3 months after operation, and none of them was over 150 μm. Conclusions Confocal microscopy can be used to observe corneal pathology in vivo and in vivo objectively. It is a useful method to observe corneal healing after LASIK. Meanwhile, the thickness of corneal flap is affected by many factors. The thickness accuracy is expected to be further improved.