准分子激光治疗性角膜切削术联合羊膜移植术的实验研究

A study of phototherapeutic keratotomy combined with amniotic membrane transplantation in rabbit cornea

目的探讨保存人羊膜移植对角膜伤口愈合的影响。方法新西兰白兔27只(54眼),双眼同时行准分子激光治疗性角膜切削术(PTK),一眼作为实验组,术后立即于角膜表面移植保存人羊膜,另一眼作为对照组。于术后第3、5、7天及4、8周时处死动物,取角膜行光镜和电镜检查。结果术后第3、5、7天,实验组光切削区中央的角膜上皮细胞增生厚度明显小于对照组(P<0.05或P<0.01)。术后4、8周,实验组术后角膜上皮下雾状混浊(Haze)形成明显低于对照组(P<0.05)。对照组前基质层新生胶原更为紊乱,瘢痕明显,成纤维细胞功能较实验组活跃。结论羊膜具有调节角膜伤口愈合的作用,能有效减轻PTK术后Haze的形成。

Objective To study the effect of preserved amniotic membrane transplantation on healing stage of corneal wound. Methods Excimer laser phototherapeutic keratotomy （PTK） was performed on both eyes of 27 New Zealand white rabbits. Preserved human amniotic membrane transplantation was planted on one eye immediately after operation, and the other eye as the control. Cornea was observed under optical and electron microscopy examination on the 3rd, 5th, 7th day and 4,8 weeks after operation. Results The regeneration of central corneal epithelium with amniotic membrane transplantation side in the experimental group was significantly less than that in the controls on the 3rd, 5th, 7th day after operation （P〈0. 05 or P〈0.01）. Corneal haze in experimental group was significantly less than that in the controls at 4,8 weeks after operation （P〈0. 05）. New collagen fiber in Bowman membrane in the controls was more discarded than that in experimental group. Scar in experimental group was much more obvious than that in the controls. Function of collagenoblast in the controls was more active than that in experimental group. Conclusion Amniotic membrane may regulate the healing of corneal wound, and effectively reduce the Haze after PTK.