CAJ | 학술논문

目的评价和了解准分子激光屈光性角膜切削术(PRK)对角膜内皮细胞密度和形态的远期影响,并探究其与切削深度、激光扫描时间等手术参数的相关性.方法回顾性病例研究.PRK术后10年患者24例(44眼);随机选取未接受过眼科手术的正常眼作为对照组,共25例(45眼).应用非接触角膜内皮镜测量角膜中央内皮细胞密度和形态.利用Pearson线性相关分析研究PRK术后10年组内皮细胞密度和形态与手术参数间的相关性.另将PRK术后10年患者按切削量大小分为低切削(＜60 μm)、中切削(60～90μm)和高切削(＞90 μm)3组,并对比分析此3组及对照组间角膜中央内皮细胞密度和形态的差异.采用独立样本t检验、Pearson相关分析、单因素方差分析进行数据处理.结果 PRK术后10年组与对照组间平均内皮细胞面积、内皮细胞密度、内皮细胞面积变异系数、六边形内皮细胞百分比的差异均无统计学意义(t=-1.390、1.323、0.569、0.788,P＞0.05).平均内皮细胞面积和内皮细胞密度与等效球镜度间具有明显相关性(r=-0.424、0.420,P＜0.01),同时该两参数与准分子预切削深度间亦显示具有相关关系(r=0.391、-0.388,P＜0.01).PRK术后低、中、高切削组与对照组间平均内皮细胞面积、内皮细胞密度、内皮细胞面积变异系数、六边形内皮细胞百分比的差异均无统计学意义(F=2.195、1.961、0.817、1.529,P＞0.05).结论 PRK术后远期角膜中央内皮细胞密度及形态无明显异常改变.等效球镜度及预切削深度会影响平均内皮细胞面积和内皮细胞密度.
목적 평개화료해준분자격광굴광성각막절삭술(PRK)대각막내피세포밀도화형태적원기영향,병탐구기여절삭심도、격광소묘시간등수술삼수적상관성.방법 회고성병례연구.PRK술후10년환자24례(44안);수궤선취미접수과안과수술적정상안작위대조조,공25례(45안).응용비접촉각막내피경측량각막중앙내피세포밀도화형태.이용Pearson선성상관분석연구PRK술후10년조내피세포밀도화형태여수술삼수간적상관성.령장PRK술후10년환자안절삭량대소분위저절삭(＜60 μm)、중절삭(60～90μm)화고절삭(＞90 μm)3조,병대비분석차3조급대조조간각막중앙내피세포밀도화형태적차이.채용독립양본t검험、Pearson상관분석、단인소방차분석진행수거처리.결과 PRK술후10년조여대조조간평균내피세포면적、내피세포밀도、내피세포면적변이계수、륙변형내피세포백분비적차이균무통계학의의(t=-1.390、1.323、0.569、0.788,P＞0.05).평균내피세포면적화내피세포밀도여등효구경도간구유명현상관성(r=-0.424、0.420,P＜0.01),동시해량삼수여준분자예절삭심도간역현시구유상관관계(r=0.391、-0.388,P＜0.01).PRK술후저、중、고절삭조여대조조간평균내피세포면적、내피세포밀도、내피세포면적변이계수、륙변형내피세포백분비적차이균무통계학의의(F=2.195、1.961、0.817、1.529,P＞0.05).결론 PRK술후원기각막중앙내피세포밀도급형태무명현이상개변.등효구경도급예절삭심도회영향평균내피세포면적화내피세포밀도.
Objective To evaluate and determine the long-term effects of photorefractive keratectomy (PRK) on corneal endothelial cell density and morphology,and investigate their correlation with surgically designed parameters such as ablation depth and laser scan time.Methods In this retrospective study,24 patients (44 eyes) who underwent PRK 10 years earlier and 45 normal eyes of 25 cases without any ophthalmologic surgery were enrolled in this study as the PRK group and the control group,respectively.Noncontact specular microscopy (Topcon,SP3000P,Japan) was used to measure central corneal endothelial cell density and morphology.A Pearson correlation was used to analyze the relationship between corneal endothelial cell density and morphology,and surgically designed parameters.The PRK group was divided into 3 subgroups based on the depth of tissue ablation:low ablation group (ablation depth ＜60 μm),moderate ablation group (ablation depth:60～90 μm) and high ablation group (ablation depth ＞90 μm).The differences in corneal endothelial cell density and morphology between these 3 groups and the control group were analyzed.Data were analyzed using independent samples t test,Pearson correlation,ANOVA.Results The differences in average endothelial cell area,endothelial cell density,coefficient of variation of the endothelial cell area and percentage of hexagonal cells between the PRK group and control group were not statistically significant (t=-1.390,1.323,0.569,0.788,P＞0.05).However,there were statistically significant correlations between average endothelial cell area and endothelial cell density and manifest refraction spherical equivalent (MRSE) (r=-0.424,0.420,P＜0.01).The 2 parameters were also significantly correlated with attempted ablation depth (r=0.391,-0.388,P＜0.01).The differences in average endothelial cell area,endothelial cell density,coefficient of variation of the endothelial cell area and percentage of hexagonal cells between the low ablation group,moderate ablation group,high ablation group and control group were not statistically significant (F=2.195,1.961,0.817,1.529,P＞0.05).Conclusion Compared to normal eyes,no significantly abnormal change in central corneal endothelial cell density or morphology was observed 10 years after PRK.MRSE and attempted ablation depth may have an effect on the average endothelial cell area and endothelial cell density.