重度碱烧伤早期异种去细胞角膜材料移植

Urgent acellular corneal stroma materials kertoplasty in the treatment to severe eye burns

目的 观察重度碱烧伤后，早期（伤后1周内）行异种去细胞角膜材料板层移植手术治疗的可行性和疗效，并与同种异体角膜材料进行比较性研究。方法 将19只新西兰大白免制作成角膜重度碱烧伤模型，伤后1周，取16只随机分为2组，每组8只。一组行猪去细胞角膜材料板层移植；另一组行同种异体板层兔角膜移植。其余3只烧伤后不作任何处理，为空白对照组。术后进行大体观察、裂隙灯、病理学、角膜内皮染色观察。结果重度碱烧伤异种去细胞角膜材料移植后2～3周，有新生血管侵入植片边缘，植片为灰白色半透明状，移植区角膜上皮愈合。6周后，角膜植片新生血管开始减退，植片局部变透明。观察至28周，植片存活良好，无免疫排斥反应发生，炎症静止，眼表维持相对正常的结构，与同种异体角膜移植组治疗效果相同，可为以后的增视性手术创造良好的条件。结论用异种去细胞角膜基质材料对重度碱烧伤角膜进行移植手术治疗，可减轻伤后炎症反应，防止严重并发症的发生，维持了眼表结构。疗效与同种异体角膜移植相同。

Objective To observe the feasibility and curative effect of the transplantation of heterogeneite acellular cornea stroma materials on cornea stroma with ponderosus alkali adustum （with-in one week） and compare stroma materials with homogeneity. Methods Nineteen New-Zealand rabbits were made as the modes of cornea stroma with ponderosus alkali adustum and were randomly divided into 3 groups after one week： cornea stroma of experimental group（8 rabbits） was transplanted with acellular cornea stroma materials of swine, the acellular cornea stroma materials of swine was replaced by it of rabbit in the control group（ 8 rabbits） and it had not any deal with in the blank group（3 rabbits）. Then the cornea stroma was observed by in general, slit lamp, pathematology, and corneal endothelium staining. Results After 2- 3 weeks, the implant＇s margin of the experimental group was invasioned by new vessels and became grey and semitransparent. After 6 weeks, new vessels of the implant began to decrescence and partis of it became transparence. In the time of 28 week, the implant survived well, had no immune rejection and inflammation. The therapeutic efficacy and ophthahnos structure of the experimental group were same as the control group. The study could create favourable condition for transplantion. Conclusion Heterogeneity acellular corneal stroma materials can be successfully used to repair ponderosus alkali adustum,and the curative effect is same as homogeneity.