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[摘要]
目的：观察飞秒激光制瓣LASIK术后角膜内皮细胞的形态。
方法：随机选取2013-05/09接受飞秒激光制瓣LASIK手术的近视患者45例88眼，术前、术后1mo和术后1a时，使用非接触式角膜内皮细胞仪测量患者角膜中央区单位面积内的角膜内皮细胞形态，测量指标包括角膜内皮细胞数目、角膜内皮细胞密度、六边形细胞百分比、角膜内皮细胞平均面积、角膜内皮细胞面积标准差和细胞面积变异系数等，对测量结果进行统计学分析。
结果：所有患者手术顺利，随访期内未见并发症发生； 术后1mo时患者角膜内皮细胞密度为2 815.34±297.07个/mm2，较术前减少2.64%(t=4.60，P=0.00)，术后1mo和术后1a的角膜内皮细胞密度差异无统计学意义(P>0.05)； 术后1mo时患者角膜内皮细胞面积标准差为118.47±31.58μm2，较术前显著增加(t=-3.87，P=0.03)，而术后1mo和术后1a角膜内皮细胞面积标准差测量值差异无统计学意义(P>0.05)； 角膜内皮细胞数目、六边形细胞百分比、角膜内皮细胞平均面积和细胞面积变异系数等指标在手术前后各时间点的测量值差异均无统计学意义(P>0.05)。
结论：飞秒激光制瓣LASIK术后早期角膜内皮细胞密度较术前轻度下降，但角膜内皮细胞功能未受到显著影响，随访期内未发生进行性角膜内皮细胞丢失。
[Key word]
[Abstract]
AIM: To observe the morphology of corneal endothelial cells after femtosecond laser
in situ keratomileusis(Femto-LASIK).
METHODS: From May to September in 2013, 88 eyes of 45 patients with myopia who accepted Femto-LASIK were enrolled in this study. The morphology of central corneal endothelial cells was measured by a non-contact corneal endothelial cell analyzer before, 1mo and 1a after surgery. The number, density, average size, size standard deviation, size coefficient of variation and hexagonality of the corneal endothelial cells were observed. All the measurements were analyzed by statistical analysis.
RESULTS: All patients underwent operation smoothly, and no complication was observed during and after surgery; One month after surgery, the endothelial cell density(ECD)was 2 815.34±297.07/mm2, which had a 2.64% decrease compared with preparative ECD(t=4.60, P=0.00), there was no statistical significance between ECD measurements of 1mo and 1a after surgery(P>0.05); One month after surgery, the size standard deviation(SSD)was 118.47±31.58μm2, which increased significantly compared with the preoperative SSD(t=-3.87, P=0.03), there was no statistical significance between SSD measurements of 1mo and 1a after surgery(P>0.05); After surgery, the number, hexagonality, average size and size coefficient of variation of the corneal endothelial cells didn't change statistically(P>0.05).
CONCLUSION: In the early period after Femto-LASIK, the ECD decreased slightly, however this kind of surgery did not have significant harm to the function of corneal endothelial cells, and the surgery didn't cause the progressive loss of corneal endothelial cells.
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