CAJ | 학술논문

目的探讨共焦显微镜对近视人群中央角膜各层组织的活体观察和分析.方法选择2003年8月-2007年12月天津医科大学眼科中心进行屈光手术术前检查者122例(122眼),其中男54例(54眼),女68例(68眼);年龄18～80岁,平均(28.54±12.4)岁;等效屈光度数为-0.50~-6.0D.检查并记录各层角膜图像,并对各层细胞形态、细胞密度进行分析.结果角膜全层厚度、基质厚度与年龄均呈负相关(r_1=-0.552,P=0.014;r_2=-0.545,P=0.035).上皮层基底膜细胞密度与年龄呈负相关(r=-0.355,P=0.017).前基质、后基质细胞密度与年龄均呈负相关(r_1=-0.462;P=0.001;r_2=-0.403,P=0.016).内皮细胞密度与年龄呈负相关(r=-0.603,P=0.006).随着年龄的增长,角膜内皮细胞发生了形态学改变,内皮细胞的多形性百分比增大,六边形细胞数的百分比下降(r_1=0.417,P=0.004;r_2=-0.598,P=0.002).结论近视人群中央角膜组织随着年龄的增长,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.
목적 탐토공초현미경대근시인군중앙각막각층조직적활체관찰화분석.방법 선택2003년8월-2007년12월천진의과대학안과중심진행굴광수술술전검사자122례(122안),기중남54례(54안),녀68례(68안);년령18～80세,평균(28.54±12.4)세;등효굴광도수위-0.50~-6.0D.검사병기록각층각막도상,병대각층세포형태、세포밀도진행분석.결과 각막전층후도、기질후도여년령균정부상관(r_1=-0.552,P=0.014;r_2=-0.545,P=0.035).상피층기저막세포밀도여년령정부상관(r=-0.355,P=0.017).전기질、후기질세포밀도여년령균정부상관(r_1=-0.462;P=0.001;r_2=-0.403,P=0.016).내피세포밀도여년령정부상관(r=-0.603,P=0.006).수착년령적증장,각막내피세포발생료형태학개변,내피세포적다형성백분비증대,륙변형세포수적백분비하강(r_1=0.417,P=0.004;r_2=-0.598,P=0.002).결론 근시인군중앙각막조직수착년령적증장,각막상피기저막세포、각막기질세포、각막내피세포수량하강,각막전층、각막기질후도감소.
Background Corneal confocal microscopy can denamically offer the morphological image of corneal cells at cellular level.To find out the dynamic change of corneal thickness and morphology of corneal cells with aging is very important for the design of corneal refractive surgery.ObjectivePresent study is to find out the important relevance of dynamic change of corneal thickness and morphology of corneal cells with aging and the design of corneal refractive surgery and investigate the influence of age on central corneal tissue and characterize precisely the anatomy of cornea by in vivo confocal microscopy.Methods122 eyes of 122 normal subjects were enrolled in this study with the age from 18 through 80 years old.The subjects were diagnosed as emmetropia in the Center of Tianjin Medical University from August 2003 to December 2007.All eyes were examined in vivo by confocal microscopy.The cell morphology,cell density and corneal thickness were measured by confocal microscopy.The relationship of central corneal tissue change and age was evaluated.ResultsThe density of corneal superficial basement epithelial cells showed a significantly negative correlation with age (r=-0.355,P=0.017).The keratocyte density in the anterior and posterior stroma indicated a significantly negative correlation with age (r_1=-0.462,P=0.001;r_2=-0.403,P=0.016).The thickness of corneal epithelium cells had a significantly negative correlation with age (P=0.02).The mean value of total corneal thickness and stromal thickness in high myopic eyes was (523.2±26.20)μm and (468.4±20.72)μm respectively,presenting a significantly negative correlation with age (r_1=-0.552,P=0.014;r_2=-0.545,P=0.035).A significantly negative correlation was also found in endothelial cell areas and density with age (r_1=0.417,P=0.004;r_2=-0.598,P=0.002).The percentage of polymorphological corneal endothelial cells was considerably increased(r=0.417,P=0.004)but that of pleomorphism cells was significantly decreased in >60-year-old population compared with younger subjects (r=-0.598,P=0.002).The morphology of corneal basement cell,anterior stroma cytocyte and endothelial cell were normal in younger subjects,and enlargement of the cells in size,decreases of number and density of the cells were found in >60-year-old subject.ConclusionThe anatomy and histology of the central cornea in young subjects exist discrepancy from older ones.The corneal hisological changes with aging include thinner thickness of epithelium,thinner thickness of cornea,decreased density of keratocyte and endothelial cells and increased size of endothelial cells.Corneal thickness is asymmetric and seems to undergo age-related anatomic changes.