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Confocal microscopy features in chronic corneal edema

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Author:: No author available

Journal Title:: International Eye Science

Issue:: 12

DOI:: 10.3980/j.issn.1672-5123.2019.12.30

Key Word:: 共焦显微镜;慢性角膜水肿;大泡性角膜病变;角膜

Abstract：目的:应用活体共焦显微镜(IVCM)观察慢性角膜水肿患者角膜各层形态特点.方法:使用IVCM观察不同病因的慢性角膜水肿的患者21例21眼,并与5例拟行白内障手术患者的正常角膜进行对照.结果:IVCM观察到所有慢性角膜水肿患者角膜上皮层均可见大泡,表现为黑色、圆形、边缘清晰.18眼(86％)上皮细胞出现高反射的无细胞结构的片状区域和瘢痕.12眼(57％)患者中央区角膜上皮下未发现神经纤维,9眼(43％)患者中央区角膜上皮下神经平均密度显著降低.所有患者Bowman膜(BZ)表现为明显的异常,除了瘢痕外,BZ呈分支的、细的、黑线状.13眼(62％)患者前基质表现为细颗粒或粗颗粒,且反光不同.所有患者角膜基质细胞密度降低.所有患者角膜内皮表现为正常六边形结构消失,细胞边界不清.对照组角膜正常未见上述改变.结论:IVCM可以用来观察慢性角膜水肿角膜各层微观结构上的变化,包括上皮瘢痕形成、上皮下神经纤维及基质细胞的减少.随着角膜内皮移植术的日益普及,本研究支持IVCM在定量评估术前、术后角膜水肿的作用.

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