中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2014年
11期
833-838
,共6页
吴丹%洪佳旭%王飞%崔心瀚%杨宇靖%赵玉瑾%徐建江
吳丹%洪佳旭%王飛%崔心瀚%楊宇靖%趙玉瑾%徐建江
오단%홍가욱%왕비%최심한%양우정%조옥근%서건강
翼状胬肉%角膜缘%角膜厚度测量%傅里叶分析%体层摄影术,光学相干
翼狀胬肉%角膜緣%角膜厚度測量%傅裏葉分析%體層攝影術,光學相榦
익상노육%각막연%각막후도측량%부리협분석%체층섭영술,광학상간
Pterygium%Limbus corneae%Corneal pachymetry%Fourier analysis%Tomography,optical coherence
目的 探讨通过傅立叶域OCT(FD-OCT)观察角膜缘上皮厚度的可行性及翼状胬肉切除联合自体结膜移植术患者围手术期角膜缘上皮厚度的变化规律.方法 前瞻性研究.选择2013年7至9月在复旦大学附属眼耳鼻喉科医院诊断为翼状胬肉的连续病例22例(24只眼),另选取志愿者25例(25只眼)为对照组.试验组行翼状胬肉切除联合自体结膜移植术,于术前、术后第1、2、3、5、7天进行随访,记录患者症状指标、FD-OCT检测角膜缘内1和2 mm处上皮厚度、裂隙灯检查记录角膜荧光素染色面积大小.采用成组t检验比较对照组与试验组的组间差异.重复测量方差分析比较试验组患者术后不同时间角膜缘内1和2 mm处上皮厚度和术后角膜荧光素染色面积差异.结果 对照组鼻侧角膜缘内1 mm处角膜上皮厚度为(43.81 ±2.55) μm,试验组术后第1、2、3、5、7天此处角膜上皮厚度分别为(21.28 ±5.72)、(27.21 ±4.82)、(31.51 ±5.09)、(34.10 ±4.12)、(39.94±5.47)μm,与对照组相比差异均有统计学意义(t=-17.69,-14.97,-10.63,-9.86,-3.15;P＜0.05).对照组鼻侧角膜缘内2 mm处角膜上皮厚度为(40.50±3.17) μm,试验组术后第1、2、3、5、7天此处角膜上皮厚度分别为(24.02±5.92)、(29.09±4.53)、(33.08 ±4.77)、(36.55±5.71)、(40.34±5.69) μm,除第7天外,与对照组相比差异均有统计学意义(t=-12.08,-10.27,-6.18,-2.99;P ＜0.05).术后第1天角膜上皮缺损(荧光素染色阳性)面积为(39.31 ±22.77) mm2,至术后第7天减小至(1.01 ±1.72) mm2,术后第2、3天同前相比,角膜荧光素染色面积差异存在统计学意义(t =6.68,5.55;P＜0.05);术后第5、7天同前相比差异无统计学意义(t=1.37,2.09;P＞0.05).术后第7天,角膜上皮荧光素染色阴性率为66.7％.结论 FD-OCT是观察角膜缘上皮厚度的有效工具.翼状胬肉切除术后角膜缘上皮呈现从角膜中央部到周边逐步修复的规律.
目的 探討通過傅立葉域OCT(FD-OCT)觀察角膜緣上皮厚度的可行性及翼狀胬肉切除聯閤自體結膜移植術患者圍手術期角膜緣上皮厚度的變化規律.方法 前瞻性研究.選擇2013年7至9月在複旦大學附屬眼耳鼻喉科醫院診斷為翼狀胬肉的連續病例22例(24隻眼),另選取誌願者25例(25隻眼)為對照組.試驗組行翼狀胬肉切除聯閤自體結膜移植術,于術前、術後第1、2、3、5、7天進行隨訪,記錄患者癥狀指標、FD-OCT檢測角膜緣內1和2 mm處上皮厚度、裂隙燈檢查記錄角膜熒光素染色麵積大小.採用成組t檢驗比較對照組與試驗組的組間差異.重複測量方差分析比較試驗組患者術後不同時間角膜緣內1和2 mm處上皮厚度和術後角膜熒光素染色麵積差異.結果 對照組鼻側角膜緣內1 mm處角膜上皮厚度為(43.81 ±2.55) μm,試驗組術後第1、2、3、5、7天此處角膜上皮厚度分彆為(21.28 ±5.72)、(27.21 ±4.82)、(31.51 ±5.09)、(34.10 ±4.12)、(39.94±5.47)μm,與對照組相比差異均有統計學意義(t=-17.69,-14.97,-10.63,-9.86,-3.15;P＜0.05).對照組鼻側角膜緣內2 mm處角膜上皮厚度為(40.50±3.17) μm,試驗組術後第1、2、3、5、7天此處角膜上皮厚度分彆為(24.02±5.92)、(29.09±4.53)、(33.08 ±4.77)、(36.55±5.71)、(40.34±5.69) μm,除第7天外,與對照組相比差異均有統計學意義(t=-12.08,-10.27,-6.18,-2.99;P ＜0.05).術後第1天角膜上皮缺損(熒光素染色暘性)麵積為(39.31 ±22.77) mm2,至術後第7天減小至(1.01 ±1.72) mm2,術後第2、3天同前相比,角膜熒光素染色麵積差異存在統計學意義(t =6.68,5.55;P＜0.05);術後第5、7天同前相比差異無統計學意義(t=1.37,2.09;P＞0.05).術後第7天,角膜上皮熒光素染色陰性率為66.7％.結論 FD-OCT是觀察角膜緣上皮厚度的有效工具.翼狀胬肉切除術後角膜緣上皮呈現從角膜中央部到週邊逐步脩複的規律.
목적 탐토통과부립협역OCT(FD-OCT)관찰각막연상피후도적가행성급익상노육절제연합자체결막이식술환자위수술기각막연상피후도적변화규률.방법 전첨성연구.선택2013년7지9월재복단대학부속안이비후과의원진단위익상노육적련속병례22례(24지안),령선취지원자25례(25지안)위대조조.시험조행익상노육절제연합자체결막이식술,우술전、술후제1、2、3、5、7천진행수방,기록환자증상지표、FD-OCT검측각막연내1화2 mm처상피후도、렬극등검사기록각막형광소염색면적대소.채용성조t검험비교대조조여시험조적조간차이.중복측량방차분석비교시험조환자술후불동시간각막연내1화2 mm처상피후도화술후각막형광소염색면적차이.결과 대조조비측각막연내1 mm처각막상피후도위(43.81 ±2.55) μm,시험조술후제1、2、3、5、7천차처각막상피후도분별위(21.28 ±5.72)、(27.21 ±4.82)、(31.51 ±5.09)、(34.10 ±4.12)、(39.94±5.47)μm,여대조조상비차이균유통계학의의(t=-17.69,-14.97,-10.63,-9.86,-3.15;P＜0.05).대조조비측각막연내2 mm처각막상피후도위(40.50±3.17) μm,시험조술후제1、2、3、5、7천차처각막상피후도분별위(24.02±5.92)、(29.09±4.53)、(33.08 ±4.77)、(36.55±5.71)、(40.34±5.69) μm,제제7천외,여대조조상비차이균유통계학의의(t=-12.08,-10.27,-6.18,-2.99;P ＜0.05).술후제1천각막상피결손(형광소염색양성)면적위(39.31 ±22.77) mm2,지술후제7천감소지(1.01 ±1.72) mm2,술후제2、3천동전상비,각막형광소염색면적차이존재통계학의의(t =6.68,5.55;P＜0.05);술후제5、7천동전상비차이무통계학의의(t=1.37,2.09;P＞0.05).술후제7천,각막상피형광소염색음성솔위66.7％.결론 FD-OCT시관찰각막연상피후도적유효공구.익상노육절제술후각막연상피정현종각막중앙부도주변축보수복적규률.
Objective To evaluate the change of corneal epithelial thickness after pterygium excision with conjunctival autograft transplantation by Fourier Domain Optical Coherence Tomography (FD-OCT).Methods Twenty-two patients (24 eyes) with the diagnosis of primary pterygium were enrolled.They underwent pterygium excision combined with conjunctival autograft transplantation.Twenty-five volunteers (25 eyes) served as the normal control group.FD-OCT was performed preoperatively and 1,2,3,5,7 days postoperatively to measure the thickness of corneal epithelium at 1 mm and 2 mm anterior to the nasal or temporal scleral spur.Corneal fluorescein staining was performed simultaneously.Comparisons on the thickness of corneal epithelium were made between preoperative values and postoperative ones.Results The thickness of cornea epithelium at 1 mm anterior to the scleral spur was (43.81 ± 2.55) μm in normal subjects.At day 1 after surgery,corneal epithelial thickness at the same location was (21.28 ± 5.72) μm and then gradually increased to (39.94 ± 5.47) μm at day 7 postoperatively.All the difference on postoperative days had statistically significant(t =-17.69,-14.97,-10.63,-9.86,-3.15,P ＜ 0.05).The thickness of cornea epithelium at 2 mm anterior to the scleral spur was (40.50 ± 3.17) μm in normal subjects.At day 1 after surgery,corneal epithelial thickness at the same location was (24.02 ± 5.92) μm,and then gradually increased to (940.34 ± 5.69) μm at day 7 postoperatively.All the difference on postoperative days except day 7 had statistically significant (t =-12.08,-10.27,-6.18,-2.99,P ＜ 0.05).Cornea epithelium at this location repaired sooner than that at 1 mm anterior to the scleral spur.At day 1 after surgery,corneal epithelium defect area were (39.31 ± 22.77) mm2,and then decreased to (1.01 ± 1.72) mm2 at 7 days (t =6.68,5.55,P ＜ O.05).At day 7 postoperative,66.7％ patients had a complete recovery of corneal epithelium with no fluorescein staining.Conclusions FD-OCT was the effective instrument for observing the change of limbus-peripheral cornea epithelium thickness.Within 7 days postoperatively,cornea epithelium restored almost normal.After pterygium surgery,limbus-peripheral cornea epithelium restoration showed the tendency from the central to peripheral cornea.
