【摘要】 目的研究准分子激光原位角膜磨镶术(LASIK)术后角膜基质的改变。方法选择LASIK患者24例(48眼),于术后第1、10、30和90 d进行角膜中央部位共聚焦显微镜检查。结果48眼(100%)角膜瓣基质有微皱褶,在瓣与基质床界面处可见高反光颗粒。界面上下可见激活细胞,激活细胞所在区域深度与角膜瓣厚度呈负相关性(r1=-0.554,P=0.047);与削切深度呈正相关(r2=0.559,P=0.010),后基质细胞术后有所增加,1个月(P=0.000)时达到最高,3个月时又下降,但仍高于术前(P=0.000)。结论LASIK术后角膜基质可见微皱和高反光颗粒,基质细胞被激活,界面两侧基质中出现无细胞区。后基质细胞密度有所增加。更多还原

【Abstract】 ObjectiveLaser in situ keratomileusis（LASIK） is a refractive operation to keep corneal anatomy function,but the postoperative wound healing should be still concerned.In the present study,we aimed to evaluate corneal stromal changes using confocal microscopy at early stage after LASIK.MethodsForty-eight eyes of 24 patients underwent examination under the in vivo confocal microscopy for the evidence of corneal wound healing before and day 1,10,30 and 90 after LASIK.ResultsMicrofolds in Bowman’s layer and anterior stroma as well as various reflective particles at interface were presented in 48 eyes（100%） following LASIK.The activated-cells were displayed at interface area of corneal stroma and the depth of activated-cell area was negatively correlated with corneal flap thickness(r₁=-0.554,P=0.047)and positively correlated with ablative depth(r₂=0.559,P=0.010).The density of keratocyte in posterior stroma was gradually increased from the 10th postoperative day（784±51） and peaked at 1 month（823±50） in comparison with preoperation（733±84）（P<0.05,P<0.01）,and that in anterior stroma was not significantly altered（P>0.05）.Corneal epithelium thickness was significantly increased at postoperative day 1 and 10（54.32±6.27,55.18±5.49）in comparison with preoperation（49.16±8.92） and postoperative month 1 and 3（51.05±4.78,50.19±5.50）.ConclusionThe microfolds at the Bowman’s layer were found in all eyes,and particles of variousl reflectivity locate at the interface postoperatively.The density of keratocyte in the posterior stroma is significantly increased.The thickness of activated-cell area show significant correlation with the flap thickness and the ablative depth.In the anterior stroma,there are cellular-free zones at both of the interface area.更多还原