角膜表面镜片术的实验研究

Anexperimentalstudyonepikeratophakia

目的研究兔角膜表面镜片术后不同时期的角膜变化及免疫状态的改变。方法应用组织学及免疫组化染色法对２０只兔角膜表面镜片术后的角膜上皮修复、层间愈合、内皮细胞及上皮中郎格罕细胞（Ｌａｎｇｅｒｈａｎｓｃｅｌ，ＬＣ）进行动态观察。结果术后第４～１２天，平均７．７天上皮修复，１个月恢复正常形态和功能。术后第７天和１４天分别在镜片的周边部和上皮侧中央部出现少量角膜细胞，２个月时角膜细胞恢复正常。术后３天角膜缘部ＬＣ开始增加，１４天达高峰，２个月恢复正常。结论该手术对内皮细胞无明显影响，２个月时层间愈合良好，各层恢复正常，未发现免疫反应，为一种简便、安全的屈光手术。

ObuectiveThestudyasdeignedtoinvesigatehecorealchngesatvarioustimesaf-terepikeratophakiaperformedonrabbitcornea.MethodsTheprocesesofepithelialrepair,ofin-ter-layerhealing,thechangesofendothelialcelsandLangerhanscels(LC)incornealepitheliumwereobservedatdiferentintervalsaftersurgerybyusinghistochemistrytechnique.ResultsTheepithelialrepairofthegraftwascompletedby4-12postoperativedays.Therepopulationofkerato-cyteswasseenfirstlyatperipheralandsuperiorpartofthelenticuleat7-14postoperativedaysandcompletedtonor-malbypostoperative2months.Nochangeswereobservedintheendothelialcels.TheproliferationofLCwasobservedinthelimbalepitheliumatday3,reachedthepeakatday14andrecoveredtonormalatmonth2postoperatively.ConclusionEpikeratophakiaisavailableandsafe.TheproliferationofLCmightresultfromwoundhealingnotfromimmunerejection.