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目的观察激光角膜光学切除术（ｐｈｏｔｏｒｅｆｒａｃｔｉｖｅｋｅｒａｔｅｃｔｏｍｙ，ＰＲＫ）对角膜内皮细胞损伤的可能性。方法采用有血清和无血清培养正常兔角膜和ＰＲＫ切削深１５０μｍ角膜１ｗｋ后，观察内皮细胞形态和内皮细胞密度。结果ＰＲＫ切削深１５０μｍ无血清培养１ｗｋ后，角膜内皮细胞形态、大小不一，部分细胞边界染色较宽，内皮细胞密度明显低于对照组（Ｐ＜０．０５）。ＰＲＫ切削深１５０μｍ有血清培养１ｗｋ后，角膜内皮细胞形态及大小与对照组基本一致，边界染色均匀，内皮细胞密度与对照组无明显差异（Ｐ＞０．０５）。结论ＰＲＫ切削深１５０μｍ对角膜内皮细胞具有一定影响。血清中具有保护内皮细胞损伤的因子存在。临床上未能检测到内皮细胞缺失，可能是由于房水中存在保护内皮细胞损伤的因子。
Objective To observe the possibility of corneal endothelial cell injury by photorefractive keratectomy (PRK). Methods Normal rabbit cornea and serum were used to culture cornea and PRK cut cornea 150μm deep 1wk, endothelial cell morphology and endothelial cell density were observed. Results The corneal endothelial cells were different in size and shape after PRK cutting 150μm deep serum-free medium for 1wk. Some of the cell borders were stained broadly and the endothelial cell density was significantly lower than that of the control group (P <0.05). The corneal endothelial cells morphology and size were similar to those of the control group, the border staining was uniform and the endothelial cell density was not significantly different from that of the control group (P> 0.05). Conclusion PRK cutting 150μm deep corneal endothelial cells have a certain impact. Serum has a protective factor of endothelial cell damage exists. Clinically failed to detect endothelial cell loss may be due to the presence of aqueous humor protective factor of endothelial cells.