摘要
目的基于活体共聚焦显微镜对青光眼小梁切除术后患者滤过泡进行细胞水平的动态观察。方法选取2022年7月至2023年7月我院60例(60只眼)青光眼小梁切除术后眼压控制在21mmHg以下(包括使用1种降眼压药物)的患者为研究对象,根据术后3个月时裂隙灯生物显微镜下滤过泡形态(Kronfeld分型法)将患者分为功能性滤过泡组(30只眼)和非功能滤过泡组(30只眼);两组患者均于术后第2周、术后1个月、2个月、3个月进行了活体共聚焦显微镜检查,分析两组患者不同检查时间点微囊泡、结缔组织的差异及滤过泡上皮下组织血管化情况。结果术后2周两组患者滤过泡内均存在大量微囊泡,但随着术后时间的延长两组患者微囊泡数量均降低,非功能性滤过泡组微囊泡下降的速度更快(P<0.05),微囊泡数量更低,微囊泡直径也更小;两组患者术后滤过泡壁结缔组织致密性均随术后时间的延长升高,但术后1个月、2个月、3个月非功能性组高于功能性滤过泡组(P<0.05);功能性滤过泡组滤泡区无血管或少量血管生成,在非功能性滤过泡组中血管生成明显。结论活体共聚焦显微镜能直观动态地展现青光眼小梁切除术后患者滤过泡内的结构演变趋势,为调控青光眼小梁切除术后滤过泡的形成提供依据。
Objective To observe the dynamic changes of filtering blebs in patients after trabeculectomy at the cellular level based on in vivo confocal microscope.Methods From July 2022 to July 2023,60 patients(60 eyes)after trabeculectomy for glaucoma in our hospital whose intraocular pressure was controlled below 21mmHg(including the use of one intraocular pressure lowering drug)were included as as the research object.According to the morphology of filtering blebs under slit-lamp biologic microscope by Kronfeld classification method.,the patients were divided into functional filtering bleb group(30 eyes)and non-functional filtering bleb group(30 eyes).Patients in both groups received the first in-vivo confocal microscope examination at the second week after operation,and then received a in-vivo confocal microscope examination at 1 month,2 months,3 months after operation,respectively,and recorded the differences of microcapsules,connective tissue between the two groups at different examination time points and the vascularizations of subcutaneous tissues in filtering blebs.Results Two weeks after operation,there were a large number of microcapsules in the filter vesicles of both groups,but the number of microcapsules in both groups decreased with the extension of postoperative time,and the rate of decline of microcapsules in the nonfunctional filter vesicle group was faster(P<0.05),.In both groups,the density of connective tissue in filtering bleb wall increased with postoperative time,but it was higher in non-functional filtering bleb group than in functional filtering bleb group at 1 month,2 months,3 months after operation(P<0.05).There is no vascularization or a small amount of l vascular in the follicular area of functional follicular group,but the vascularization is obvious in nonfunctional follicular group.Conclusion Confocal microscope in vivo can visually and dynamically show the structural evolution trend of filtering blebs in patients after trabeculectomy,and provide basis for regulating the formation of filtering blebs after trabeculectomy.
作者
庞彦利
台金岭
任梅彦
郭玉强
陈瑞强
张清生
PANG Yan-li;TAI Jin-ling;REN Mei-yan;GUO Yu-qiang;CHEN Rui-qiang;ZHANG Qing-sheng(Department of Glaucoma,Puyang Second People's Hospital(Puyang Eye Hospital),Puyang 457000,Henan Province,China;Department of Clinical Functional Examination,Puyang Second People's Hospital(Puyang Eye Hospital),Puyang 457000,Henan Province,China;Department of Eye Outpatient,Puyang Second People's Hospital(Puyang Eye Hospital),Puyang 457000,Henan Province,China;Department of Ophthalmology,Puyang Second People's Hospital(Puyang Eye Hospital),Puyang 457000,Henan Province,China)
出处
《罕少疾病杂志》
2025年第7期48-51,共4页
Journal of Rare and Uncommon Diseases
基金
濮阳市科技攻关项目(1805079)。
