【摘要】 目的：观察软性接触镜（ＳＣＬ）长期戴用后对角膜内皮细胞的影响，探讨如何提高ＳＣＬ使用的安全度。方法：利用非接触式角膜内皮显微镜（ＳＰ５００，ＳＥＥＤＣｏ．Ｌｔｄ），观察长期戴用ＳＣＬ的４８只眼角膜内皮细胞的改变。分为日间戴镜组（ＤＷ组）和连续过夜戴镜组（ＥＷ组），并分别探讨戴镜期间的长短与角膜内皮变化的关系。同年龄组正常非戴镜眼的角膜内皮细胞参数作为对照观察。结果：（１）９年以上ＤＷ组中与正常对照比较，细胞密度减少１０％以上，平均细胞面积增加１０％以上，而ＥＷ组中两种变化均超过２０％。（２）ＤＷ组中，平均细胞面积增加偏离正常范围的占４１％，而ＥＷ组中占５４％。（３）ＤＷ组中，细胞变异系数增加偏离正常范围的占２８％，而ＥＷ组中占４２％。结论：（１）随着戴镜年限的延长，角膜内皮细胞的数目减少，形态学的改变超出正常范围，９年以上戴镜组此种变化显著。（２）ＥＷ戴镜方式对角膜内皮细胞的影响明显高于ＤＷ方式。（３）长期戴用ＳＣＬ后是否引起角膜内皮细胞的改变存在着个体差异。（４）戴镜定期检查中，在密切注意角膜上皮状况的同时不应忽略对角膜内皮的观察。更多还原

【Abstract】 To investigate the effects of long term(>3 years)soft contact lens(SCL) wear on the corneal endothelium and how to keep safe with SCL wear,non contact specular microscopy was performed on long term (3 to 20 years)SCL wearers and the control group.94 eyes of 48 patients were divided into daily wear(DW) group and extended wear(EW)group,and the relationship between wearing length and endothelial changes was investigated respectively.After more than 9 years SCL wearing,cell density decreased more than 10%,and mean cell area increased more than 10%compared with those of the control in DW group,while both changes were more than 20% in EW group.It were found that 59% of eyes had mean cell area within the normal range in DW group,only 46% in EW group.76% of eyes had CV values within the normal range in DW group,and only 58% in EW group.These results indicated that long term soft contact lens wear produced cell loss and cell size increase,and the longer SCL wear was,the more remarkable changes were.These changes caused by extended SCL wear were more significant than those caused by daily SCL wear.更多还原