CAJ | 학술논문

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.
배경:청광안벌통상식입도안구섭상방위치,유우각막내피세포불능재생,섭상방내피세포적창상수복주요고기타구역건강내피세포적확전화연신래보상,인차회출현내피세포밀도적하강화형태개변.목적:관찰Ahmed청광안벌식입전후각막내피세포밀도급형태학적변화규률.방법:재34례(34안)의난청광안환자안구섭상상한행Ahmed청광안벌식입,이식전급이식후3,6개월대각막중앙、섭상、섭하、비상급비하구내피섭상후측정분석,득출각막내피세포밀도,병취전각막평균치,동시관찰각막내피세포형태변화,통계륙각형세포소점비례.결과여결론:Ahmed청광안벌식입후전각막내피세포적평균밀도유소하강,병재일단시간내정점진성추세(P<0.05),기중각막섭상구교중앙구하강명현,각막중앙구내피세포밀도이식전후무명현변화.이식후각막내피세포재형태학방면야발생료변화,륙각형세포비례하강,다변형세포비례증가(P<0.05).결과현시,Ahmed청광안벌식입후6개월내각막내피세포밀도정점근성하강진세,형태학특정역유소개변.제시식입과정중응주의안내조작적경유성,종이강저대각막내피세포적손해,병연장대이식후환자각막내피적감측시간.
BACKGROUND: Ahmed glaucoma valve (AGV) is usually implanted at the superotemporal area of eyes. Comeal endothelial calls 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 calls were evaluated in the superotemporal, superonasal, infratemporal, infranasal, and central corneal areas to calculate mean value of total comea before and at 3 and 6 months after surgery. Percentage of hexagonal cells was statistically summarized.RESULTS AND CONCLUSION: Mean density of corneal endothelial calls was statistically decreased following AGV implantation (P < 0.05), In particular, the decrease was obvious in the superetemporal 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 td the endothelium and prolong monitoring time of corneal endothelial cells following AGV implantation.