角膜基质内植入改性聚羟乙基丙烯酸甲脂材料的生物学反应

The biological response of cornea to incorporated moderated porous HEMA material for the skirt of a keratoprosthesis

目的评价角膜层间植入改性聚羟乙基丙烯酸甲酯(Poly(2-hydroxyethyl methacrylate,PHEMA)孔隙性材料的生物学反应。方法选用20只新西兰白兔,将PHEMA材料植入角膜基质内,定期观察。结果植入后PHEMA材料全部稳定存留于角膜内,角膜组织呈穿通性长入PHEMA材料孔隙内,现最长达12个月以上。未见PHEMA材料排出,也未发生白内障、视网膜脱离、角膜后膜等并发症。术后并发症包括睑缘红肿、畏光、流泪等刺激症状,均于术后1周内消失；组织学提示PHEMA材料孔隙内有多量的成纤维细胞并有胶原等细胞外基质沉积。电镜检查PHEMA材料周围角膜细胞功能活跃,分泌胶原,类似组织愈合过程。结论PHEMA孔隙材料是人工角膜支架的理想材料；由于该材料还可以制作成光学性能良好的光学部,故可望制成一体式人工角膜。

Objective To evaluate the biological response in vivo （cornea） to a porous poly HEMA material used as the skirt of a keratoprosthesis.Methods 20 white New Zealand rabbits were selected, the porous discs were inserted into their interlamellar cornea pockets. Then evaluations were carried out clinically, histo-logically and uhrastructurally.Results All of the implants had been retained,with no severe complications such as cataract, retrocomeal membrane formation, retinal detachment. Keratocytes migration into the implants and deposition a complex extracellular matrix in the discs were found. The keratocytes around the discs looked healthy and functionally active by TEM. The migration of cells into the discs mimics the scenario of wound repaired.Conclusion The moderated P （HEMA） is a suitable material for the skirt of a one-piece keratoprosthesis.