国际眼科纵览

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原发性青光眼及其治疗方式对角膜内皮的影响

刘爱华  东莉洁   

  1. 天津医科大学眼科医院 眼视光学院 眼科研究所 300384
  • 收稿日期:2019-08-08 出版日期:2019-10-22 发布日期:2019-10-30
  • 通讯作者: 东莉洁,Email:aitaomubang@126.com
  • 基金资助:

    国家自然科学基金面上项目(81570872);天津市应用基础与前沿技术研究计划项目(15JCYBJC24900);天津市卫生局基金项目(2011KZ103)

Effect of primary glaucoma and its treatment on corneal endothelium

Liu Aihua, Dong Lijie   

  1. Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
  • Received:2019-08-08 Online:2019-10-22 Published:2019-10-30
  • Contact: Dong Lijie, Email: aitaomubang@126.com
  • Supported by:
    National Natural Science Foundation of China (81570872); Tianjin Research Program of Application Foundation and Advanced Technology (15JCYBJC24900); Tianjin Health Bureau Fund (2011KZ103)

摘要:

正常的角膜内皮细胞具有一定的数量和特定的单层六边形结构,是维持角膜健康和透明的关键。青光眼本身的高眼压以及青光眼的药物、激光、手术治疗均可对角膜内皮产生影响。闭角型青光眼特别是急性发作时,持续时间长的高眼压可导致角膜内皮细胞密度下降;在动物实验中,高浓度抗青光眼药物可损伤角膜内皮,但在临床应用中尚无此损害;激光周边虹膜切除术可在短期内对局部角膜内皮细胞有损伤;小梁切除术后滤过泡附近角膜内皮细胞数目减少,增用丝裂霉素C后此损害加重,但作用不持续;Ahmed引流阀局部角膜内皮细胞明显减少,而EX-PRESS引流钉则无此损害;青光眼微创手术后短期内对角膜内皮细胞影响较小。(国际眼科纵览,2019, 43:317-322)

Abstract:

Normal corneal endothelial cells with a certain number and a specific monolayer hexagonal structure are the key to maintain corneal health and transparency. The high intraocular pressure of glaucoma itself, as well as the glaucoma medication, laser, and surgical treatments could affect the corneal endothelium. In angle\|closure glaucoma, especially in acute attacks, long\|term high intraocular pressure could lead to a decrease in corneal endothelial cell density. In animal experiments, high\|concentration anti\|glaucoma drugs could damage the corneal endothelium, but there was no such damage in clinical applications. Laser peripheral iridotomy could damage local corneal endothelial cells in a short period of time. The number of corneal endothelial cells near the bleb after trabeculectomy was reduced, and the damage was aggravated after the addition of mitomycin C, but the effect was not sustained. The local corneal endothelial cells were significantly reduced after the operation of Ahmed drainage valve, but EX\|PRESS drainage nails did not have this damage. The effect of minimally invasive glaucoma surgery on corneal endothelial cells was mild in the short term.(Int Rev Ophthalmol, 2019, 43:   317-322)