活体共焦显微镜研究滤过术后的滤过泡
In vivo confocal microscopy study of blebs after filtering surgery作者机构：Service d’Ophtalmologie III C.H.N.O. des Quinze-Vingts 28 rue de Charenton Paris 75012 FranceDr.
出 版 物：《世界核心医学期刊文摘(眼科学分册)》 (Digest of the World Core Medical Journals)
年 卷 期：2006年第3期
页 面：51-52页
学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学]
摘 要：Objective: To analyze bleb structure after filtering surgery at the cellular level using a new generation in vivo confocal microscope. Design: Observational case series. Participants: We retrospectively evaluated 17 filtering blebs of 13 patients after trabeculectomy. Methods: Ophthalmologic examinations included slit-lamp examination, applanation tonometry, and in vivo confocal microscopy (Heidelberg Retina Tomograph II, Rostock Cornea Module). Eyes were classified into 3 groups: (1) functioning blebs (6 eyes), (2) nonfunctioning blebs (6 eyes), and (3) functioning blebs after application of mitomycin C (5 eyes). Cellular patterns, morphologic appearance, and functional aspects of functioning and nonfunctio ning blebs were compared in a masked manner. Main Outcome Measures: In vivo confocal microscopy images were analyzed for number of intraepithelialmicrocysts,density of subepithelial connective tissue, presence of blood vessels, or encapsulation. Results: All functioning blebs had numerous intraepithelial opticallyempty microcysts, whereas all nonfunctioning blebs had none or few. Subepithelial con nective tissue was widely spaced in all functioning blebs, whereas the tissue was dense in 83.3%of nonfunctioning blebs. Functioning blebs with mitomycin C had numerous microcysts and loosely arranged subepithelial connective tissue as compared with nonfunctioning blebs. Conclusions: In vivo confocal microscopy study of blebs is an original method that agrees well with ex vivo histologic examination. The number of microcysts and the density of the subepithelial connective tissue observed with in vivo confocal microscopy are correlated with bleb function. By providing details of the structures of filtering blebs at the cellular leve l, in vivo confocal microscopy constitutes a new promising way to understand wound healing mechanisms after filtering surgery.
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