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目的 研究活体板层角膜移植术后角膜各层组织的共焦显微镜(confocalmicroscopy)形态学改变。方法 应用Confoscan 2.0共焦显微镜对板层角膜移植术后3月～3年,角膜植片稳定的患者共17例17眼,进行扫描检查,记录与分析各层角膜图像。结果 共焦显微镜上能够清楚地观察到稳定角膜的上皮细胞、基底层细胞、前弹力层,它们同正常角膜的相应细胞在图像上没有显著差别。但植片与植床的基质细胞在共焦显微镜图像上有着明显的差异。板层角膜移植术后稳定角膜植片的基质细胞,细胞核较小呈中等反光,排列较植床的基质细胞紊乱。而角膜植床的基质细胞,细胞核较大也呈中等反光,排列较植片的基质细胞稍整齐。结论 1、Confoscan 2 0共焦显微镜可活体检查板层角膜移植术后角膜组织结构和细胞的病理改变。2、板层角膜移植术后可成功的重建眼表。3、活体板层角膜移植术后稳定角膜上有自体角膜基质细胞与异体的角膜基质细胞同时共存,角膜内皮细胞的形态结构正常。4、角膜板层间的不平滑与植片基质细胞结构紊乱可能是导致板层角膜移植术后视力不佳的重要原因
Objective To study the morphological changes of confocal microscopy in corneal layers after living lamellar keratoplasty. Methods The Confoscan 2.0 confocal microscope was used to examine 17 corneal allografts and 17 corneal allografts in 3 to 3 years after lamellar keratoplasty. The corneal images were recorded and analyzed. Results Corneal epithelial cells, basal cells, prefrontal elastic layers were clearly observed on the confocal microscope. There was no significant difference in their images between the corresponding cornea and normal cells. However, there is a clear difference in the confocal microscope images between the implanted and stromal cells. Stromal keratoplasty after lamellar keratoplasty of stromal cells, the nucleus smaller was moderately reflective, arranged than the bed of stromal cells disorder. The corneal stromal cells of the stroma, the nucleus was also larger medium reflective, arranged slightly stromal stromal cells neatly aligned. Confocal 2 0 confocal microscope can be live examination of corneal tissue after corneal transplantation and pathological changes. 2, lamellar keratoplasty can be successfully reconstructed eye chart. 3, corneal living in lamellar keratoplasty corneal autologous corneal stromal cells and allogenic corneal stromal cells co-exist, corneal endothelial cell morphology is normal. 4, corneal lamellar non-smooth and implanted stromal cell structure disorder may lead to poor vision after lamellar keratoplasty an important reason