目的：探讨角膜前基质针刺术(ASP)治疗角膜上皮细胞功能障碍(CED)的临床疗效。

方法：选取2015-09/12于华中科技大学同济医学院附属协和医院眼科行ASP治疗的CED患者16例16眼，分别于术前、术后1、3mo观察裸眼视力、眼表疾病指数评分(OSDI)、角膜荧光染色、角膜上皮厚度、全角膜厚度、角膜上皮下树突状细胞密度、角膜内皮细胞密度、角膜上皮下神经丛密度。

结果：术后1mo，本组患者裸眼视力、上皮下神经丛密度均较术前明显改善，OSDI评分、角膜上皮厚度、全角膜厚度、角膜上皮下树突状细胞密度均较术前明显降低(P<0.05)，而角膜内皮细胞密度较术前无明显变化(P>0.05)。术后3mo，裸眼视力、OSDI评分、角膜上皮厚度、全角膜厚度、角膜内皮细胞密度与术后1mo无明显差异(P>0.05)，但角膜上皮下树突状细胞密度明显下降，上皮下神经丛密度明显增加(P<0.05)。

结论：ASP可以有效治疗CED及其诱发的炎症，并可修复其导致的角膜上皮下神经丛缺损。

METHODS: Sixteen patients with CED underwent ASP in Wuhan Union Hospital from September 2015 to December 2015 were included. Uncorrected visual acuity, ocular surface disease index(OSDI), corneal fluorescence staining, corneal epithelial thickness, full corneal thickness, corneal subepithelial dendritic cell density, corneal endothelial cell density and corneal epithelial nerve density were observed and recorded at preoperative, 1mo and 3mo postoperatively, respectively.

RESULTS: Totally 16 patients compared with preoperatively, there was a significant increase in uncorrected visual acuity and corneal epithelial nerve density(P<0.05)or a significant decrease in OSDI, corneal fluorescence staining, corneal epithelial thickness, full corneal thickness and corneal subepithelial dendritic cell density(P<0.05)at 1mo postoperatively; while there was no significant difference in corneal endothelial cell density(P>0.05). And compared with 1mo postoperatively, there was a significant decrease in corneal subepithelial dendritic cell density(P<0.05)and a significant increase in corneal epithelial nerve density(P<0.05)at 3mo postoperatively, while there was no significant difference in uncorrected visual acuity, OSDI, corneal fluorescence staining, corneal epithelial thickness, full corneal thickness and corneal endothelial cell density(P>0.05).

CONCLUSION: ASP was effective for CED. Corneal confocal microscopy was essential for the evaluation of ASP efficacy, which can guide the clinical work better and establish the termination of intervention.