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目的 探讨原发性开角型和闭角型青光眼患者的角膜内皮细胞密度及形态的变化。方法 青光眼患者 6 8人 12 5只眼 ,与患者年龄相匹配的正常人 32人 6 3只眼。除外角膜病、眼部炎症、外伤及接受过内眼手术的眼。采用非接触型角膜内皮显微镜观察、测量角膜内皮细胞密度和细胞面积等各项指标 ,用 Goldm an压平式眼压计测量眼压 ;分析比较不同类型青光眼各组角膜内皮细胞各项测量指标的差异。结果 青光眼组角膜内皮细胞密度[(2 386 .81± 2 89.76 ) / m m2 ]比正常对照组 [(2 5 40 .78± 195 .6 6 ) / m m2 ]明显降低 (P<0 .0 1)。其中原发性闭角型青光眼 (PACG)组角膜内皮细胞密度 [(2 2 6 2 .6 5± 338.6 4) / mm2 ]较正常组低 ,且细胞面积等各项指标均增高 (P<0 .0 1)。特别是有急性发作史的 PACG角膜内皮细胞密度 [(192 5 .16± 40 3.38) / mm2 ]明显减低 ,细胞面积等各项指标明显增高 (P<0 .0 1)。但青光眼组中原发性开角型青光眼 (POAG)组和无急性发作史的 PACG组的角膜内皮细胞各项指标与正常组相比 ,差异无显著性意义 (P>0 .0 5 )。未发现角膜内皮细胞密度与眼压间存在相关性。结论 有急性发作史的 PACG,其角膜内皮细胞密度明显低于正常人 ,且细胞面积明显增大。而 POAG和无急性发作史的PACG角膜内
Objective To investigate the changes of corneal endothelial cell density and morphology in patients with primary open-angle and angle-closure glaucoma. Methods Sixty-five eyes of patients with glaucoma and 32 eyes of 32 normal subjects matched with their age. Except keratopathy, ocular inflammation, trauma and eye surgery. Non-contact corneal endothelium microscope was used to measure the indexes of corneal endothelial cell density and cell area. The intraocular pressure (IOP) was measured with Goldm anon pressure tonometer. The corneal endothelial cells were measured and compared among different types of glaucoma difference. Results The corneal endothelial cell density in glaucoma group was significantly lower than that in the control group [(2 386.81 ± 2 89.76) / m m2] (P <0. 0 1). The density of corneal endothelial cells in primary angle-closure glaucoma (PACG) group was lower than that of normal group (P <0, P026) .0 1). In particular, PACG corneal endothelial cell density [(192 5 .16 ± 40 3.38) / mm2] with a history of acute exacerbations was significantly decreased, and cell area and other indicators were significantly increased (P <0.01). However, there was no significant difference in the indexes of corneal endothelial cells between the primary open-angle glaucoma (POAG) group and the non-acute PACG group in the glaucoma group (P> 0.05). There was no correlation between corneal endothelial cell density and intraocular pressure. Conclusions PACG with a history of acute exacerbation has a significantly lower corneal endothelial cell density than that of normal people and a marked increase in cell area. While POAG and PACG corneas without a history of acute attacks