中国组织工程研究

中国组织工程研究

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

Ahmed青光眼阀植入后角膜内皮细胞的变化

李克研1，徐韶琳2，刘  丹1，王  英1   

  1. 1辽宁医学院附属第一医院眼科，辽宁省锦州市 121001；2吉林大学第二医院眼科中心，吉林省长春市 130000
  • 出版日期:2010-01-15 发布日期:2010-01-15
  • 作者简介:李克研★，男，1979年生, 辽宁省营口市人，汉族， 2008年吉林大学毕业，硕士，主治医师，主要从事青光眼的临床诊断和治疗研究。like12345678_ren@yahoo.com.cn

Changes of corneal endothelial cells after Ahmed glaucoma valve implantation

Li Ke-yan1, Xu Shao-lin2, Liu Dan1, Wang Ying1   

  1. 1 Department of Ophthalmology, First Affiliated Hospital of Liaoning Medical University, Jinzhou   121001, Liaoning Province, China; 2 Department of Ophthalmology, Second Affiliated Hospital of Jilin University, Changchun   130000, Jilin Province, China
  • Online:2010-01-15 Published:2010-01-15
  • About author:Li Ke-yan★, Master, Attending physician, Department of Ophthalmology, First Affiliated Hospital of Liaoning Medical University, Jinzhou 121001, Liaoning Province, China like12345678_ren@yahoo.com.cn

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399

被引次数

4

摘要：

背景：青光眼阀通常植入到眼球颞上方位置，由于角膜内皮细胞不能再生，颞上方内皮细胞的创伤修复主要靠其他区域健康内皮细胞的扩展和延伸来补偿，因此会出现内皮细胞密度的下降和形态改变。
目的：观察Ahmed青光眼阀植入前后角膜内皮细胞密度及形态学的变化规律。
方法：在34例(34眼)疑难青光眼患者眼球颞上象限行Ahmed青光眼阀植入，移植前及移植后3，6个月对角膜中央、颞上、颞下、鼻上及鼻下区内皮摄像后测定分析，得出角膜内皮细胞密度，并取全角膜平均值，同时观察角膜内皮细胞形态变化，统计六角形细胞所占比例。
结果与结论：Ahmed青光眼阀植入后全角膜内皮细胞的平均密度有所下降，并在一段时间内呈渐进性趋势(P < 0.05)，其中角膜颞上区较中央区下降明显，角膜中央区内皮细胞密度移植前后无明显变化。移植后角膜内皮细胞在形态学方面也发生了变化，六角形细胞比例下降，多边形细胞比例增加(P < 0.05)。结果显示，Ahmed青光眼阀植入后6个月内角膜内皮细胞密度呈渐近性下降趁势，形态学特征亦有所改变。提示植入过程中应注意眼内操作的轻柔性，从而降低对角膜内皮细胞的损害，并延长对移植后患者角膜内皮的监测时间。

关键词: 青光眼阀, 角膜内皮, 角膜内皮计, 细胞密度, 细胞形态

Abstract:

BACKGROUND: Ahmed glaucoma valve (AGV) is usually implanted at the superotemporal area of eyes. Corneal endothelial cells cannot regenerate, so the repair of the endothelial cells mainly depend on the extension and progradation of the healthy cells in other area. Therefore, changes of density and shape are observed in the corneal endothelial cells after AGV implantation.
OBJECTIVE: To observe the changes of density and morphology of corneal endothelial cells after AGV implantation.
METHODS: Ahmed glaucoma valves were implanted in 34 eyes of 34 patients with refractory glaucoma. Density and morphology of corneal endothelial cells were evaluated in the superotemporal, superonasal, infratemporal, infranasal, and central corneal areas to calculate mean value of total cornea before and at 3 and 6 months after surgery. Percentage of hexagonal cells was statistically summarized. 　
RESULTS AND CONCLUSION: Mean density of corneal endothelial cells was statistically decreased following AGV implantation (P < 0.05), In particular, the decrease was obvious in the superotemporal area. Density of corneal endothelial cells was not changed in central area before and after AGV implantation. Morphological changes demonstrated that hexagonal cells were increased, but polygon cells were increased (P < 0.05). Density of corneal endothelial cells was gradually decreased, and morphology was also changed at 6 months after AGV implantation, suggesting that more care should be taken during intra-operation in order to minimize damage to the endothelium and prolong monitoring time of corneal endothelial cells following AGV implantation. 　

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