放射状角膜切开的实验病理与临床应用

Experimental Pathology and Clinical Observation of Radial Keratotomy

以１４只兔及２只猴为动物模型，对放射状角膜切开术（ＲＫ）进行了２～３个月观察，发现：ＲＫ切口内的上皮塞子持续２个月以上才逐渐消退，术后一个月内上皮下基底膜形成，后逐渐变薄，切口内的成纤维细胞分裂增殖较慢，开始走行与切口平行，１５天后可见横过切口，２月后实质表层成纤维细胞排列变得整齐，但深层仍较紊乱，胞核多深染。术中切穿角膜的实验兔，术后２个月病理切片可见：切口附近内皮细胞丢失，内弹力膜断裂，切口内充填了大量成纤维细胞。进行了１０例（１８眼）近视眼的ＲＫ手术，术后视力均有不同程度的提高，术后１５天达峰值，以后视力有所回降，根据实验病理所见，这种回降可能与上皮塞子的逐渐消失有关。

ourteen New Zealand rabbits and 2 Rhesus Monkeys were used to investigate the pathologic changesafter radial keratotomy(RK)for a period of 2～ 3months.The results revealed that in the rabbit and monkeymodel the epithelial plug was full of incision of RK,The epithelial plug was eliminated gradually after opera-tion 2 months. Epithelial basement membrane took shape obviously in a month after RK and appeared slightgradually. The fibroblasts proliferated more slowly than epithelia did.It was more perpendicular orientation tothe wound in the early. The fibroblasts crossed the incision by degree at the 15 days after operation. The fi-broblasts orientation of superficial stroma layer put in order after 2 months,but in deep was irregular.Thenucleus stained with intense staining.The cornea was penetrated interoperation of RK,The pathology showedthat the endothelia around incision missed,Descemet’s membrane broke off,and a number of fibroblastsfilled up incision of RK. 10 patients of myopia(18 eyes)have undergone RK procedures.The vision was in-creased with various degree after operation. The peak of vision appeared at the 15 days after operation, Here-after,the vision decreased to some extent.It might be related with the epithelial plug.