不同类型干眼对角膜地形图、角膜内皮细胞和角膜厚度的影响

摘要

Objective To investigate the effects of different types of dry eye on corneal topography,corneal endothelial cells and corneal thickness.Methods Corneal topographer was used to detect the corneal surface regularity index (SRI),corneal surface asymmetric index (SAI) and corneal surface cylinder (CYL) of insufficient tear secretion of dry eye in 28 patients (52 eyes,group A),evaporative dry eye in 29 patients (59 eyes,group B) and 26 normal controls (51 eyes,group C),and corneal endoscopy was applied to detect the corneal thickness and endothelial cells of the three groups.Results The differences of SAI and SRI between group A,group B and group C were not statistically significant (all P ＞0.05).The CYL of group A [(0.610 ±0.044) D] was significantly lower than that of group B [(0.740 ± 0.068) D] and group C [(0.870 ±0.075) D] (P =0.023,0.003),but there was no significant difference in CYL between group C and group B (P ＞ 0.05).Meanwhile,there was no significant difference in corneal thickness of all positions in group A and group B with group C (all P ＞ 0.05).The percentage of central hexagonal cells [(51.71 ± 8.27) ％] and nasal hexagonal cells [(50.83 ± 10.23)％] in group A was lower than that in group C [(56.35 ±8.66)％ and (56.08 ±7.00％)] (P =0.005,0.010),but there was no significant difference in percentage of hexagonal cells between group B and group C (all P ＞ 0.05).Conclusion Different types of dry eye have different effects on corneal topography,and may have certain influence on corneal endothelial cells,but there is no significant difference in the corneal thickness of the patients with dry eye and the normal person.%目的 探讨不同类型干眼对角膜地形图、角膜内皮细胞和角膜厚度的影响.方法 采用角膜地形图仪检测泪液生成不足型干眼28例(53眼,A组)、蒸发过强型干眼29例(58眼,B组)、正常对照组26人(51眼,C组)角膜表面规则指数(surface regularity index,SRI)、角膜表面不对称指数(surface asymmetry index,SAI)、角膜表面散光值(cylinder,CYL);采用角膜内皮镜检测3组中央、鼻侧、颞侧、上方、下方的角膜厚度及角膜内皮细胞情况,并作对比.结果 A组、B组、C组3组间SAI、SRI相比差异均无统计学意义(均为P＞0.05).A组CYL值为(0.610±0.044)D,较B组的(0.740±0.068)D和C组的(0.870±0.075)D明显降低(P=0.023、0.003),B组与C组CYL相比差异无统计学意义(P＞0.05).A组、B组各部位角膜厚度与C组相比差异均无统计学意义(均为P ＞0.05).A组中央及鼻侧六边形细胞百分比分别为(51.71±8.27)％和(50.83±10.23)％,均较C组的(56.35±8.66)％和(56.08±7.00)％降低(P =0.005、0.010),B组各部位六边形细胞百分比与C组相比差异均无统计学意义(均为P＞0.05).结论 不同类型干眼对角膜地形图的影响存在差异;干眼对角膜内皮细胞可能有一定影响;干眼患者角膜厚度与正常人相比无明显差异.