摘要
本研究应用激光共焦显微镜对各期圆锥角膜的组织结构变化进行观察,明确圆锥角膜病变发展的组织学规律.选取正常眼14例(28眼)和17例圆锥角膜眼(24眼),其中早期圆锥角膜组5眼,中期组9眼,晚期组10眼,利用激光共焦显微镜观察角膜结构.结果表明:(1)早期组的后基质层可见纵行或斜行的暗纹结构;中期组后基质层的暗纹广泛粗大,并累及前基质层;晚期组全基质层均见粗大暗纹,部分病例见细胞核拉长呈梭状,Descemet膜周围基质可呈沟壑状或放射状的断裂改变.前基质层暗纹宽度不定,层间散在高反光瘢痕,部分病例可见神经纤维与暗纹交叉处出现皱褶.正常组与各期圆锥角膜组的神经纤维密度有统计学差异(P<0.05),其神经曲折度增加,分支减少,有统计学差异(P<0.05).晚期组有3眼可见神经纤维极度迂曲缠绕成团.(2)各圆锥角膜细胞显示高反光.正常组和各期圆锥角膜组的各层角膜细胞密度无明显统计学差异(P>0.05).
This study observed the histological changes of keratoconic and normal corneas by laser confocal microscope and evaluate the microscopic development of keratoconus in different stages. 24 unscarred keratoconic corneas （17 patients） and 28 normal corneas （14 healthy adults） were examined using laser confocal microscope. The differences of the keratoconic and normal coneas were compared as follows： （1） In mild keratoconus cases, the dark stripes were seen only in the posterior stroma. In moderate cases, some tiny stripes were expanded to the anterior stromas, but still seen rarely. In advanced cases, the dark stripes were distributed to the whole stoma in a high density. The nuclei of the keratocytes were light in all keratoconic corneas. In some advanced corneas, the nuclei were stretched like shuttles. The Descemet＇s membrane was thin and collapsed and presented like the terraces in some advanced corneas. The width of the stripes in the anterior stroma changed in a small range, with some high glistened scars scattered in the stroma. In some cases, the nerve bundles and the dark stripes got crossed and caused reduetus. There were statistical differences of the density of the nerves in the four groups （P〈 0.05）. The tortuosity of the nerves increased and the branches decreased. The extreme winding nerve fibers were seen in 3 eyes of the advanced group. （2） Highly reflective keratocytes were found in the stroma of the keratoconic corneas. There were no statistical differences between the groups of the density of epithelial, anterior, posterior stroma and endothelial cells （P〉0.05）.
出处
《南京大学学报（自然科学版）》
CAS
CSCD
北大核心
2010年第2期203-209,共7页
Journal of Nanjing University（Natural Science）
基金
南京军区医药卫生专项基金(07MO86)
