AlphaCor人工角膜移植治疗兔角膜碱烧伤

Therapeutic effects of AlphaCor keratoprosthesis on alkali-burned cornea in rabbit

目的评价AlphaCor人工角膜移植对兔角膜碱烧伤的治疗效果。方法用1mol/LNaOH烧伤兔左眼建立角膜碱烧伤模型,选择角膜白斑、角膜缘新生血管>2个象限的5只兔眼行人工角膜移植术。AlphaCor人工角膜移植手术分2期进行:Ⅰ期手术,将AlphaCor人工角膜植入角膜板层间;Ⅱ期手术,暴露人工角膜光学区。术后观察人工角膜、受体角膜及眼前节情况。结果碱烧伤后2～6周形成带新生血管的角膜白斑。Ⅰ期术后5例人工角膜均在位,2例人工角膜出现白色沉积物,其中1例并发角膜浅层基质溶解,另3例无并发症发生。Ⅱ期手术中麻醉死亡1例,其余术后人工角膜均在位,1例术后6周发生角膜感染、穿孔,另3例术后4～6周发生人工角膜前膜增生,未见其他并发症发生。结论 AlphaCor人工角膜移植治疗兔角膜碱烧伤具有良好的生物相容性,效果较好。

BackgroundCorneal disease is a main cause leading to blindness.And people were looking for feasible keratoprosthesis more than 200 years.Now,we are advancing toward a perfect one.ObjectiveThe present study was to evaluate the therapeutic effects of AlphaCor keratoprosthesis on the alkali-burned cornea.MethodsThe models of alkali-burned cornea were induced by putting the filter paper with 1mol/L NaOH solution in the whole cornea of left eyes in 14 clean New Zealand white rabbits.Five eyes of 5 rabbits were enrolled in this study based on the criteria as follow：the area of corneal muddy and new vessels at the limbus was over 2 quadrants.AlphaCor keratoprosthesis was implanted on the corneas of these model eyes by two stages.In the stage Ⅰ operation,AlphaCor keratoprosthesis was implanted into corneal lamellar pocket and followed by the stage Ⅱ surgery,and then the corneal tissue at central optic zone of 3.0mm was removed.The receipt cornea and anterior segment findings in operative eye were clinically observed.Hematoxylin and eosin staining,Masson trichrome staining and alizarin red staining for corneal tissue were performed to evaluate the biocompatibility of AlphaCor keratoprosthesis.The use of the animals followed the Regulation for Administration of Affair Concering Experimental Animals by State Science and Technology Commission.ResultsThe alkali-burned models were successfully established from 2 through 6 weeks.All the keratoprosthesis remained in situ after the surgery of stage Ⅰ.The diffuse white deposition was found in 2 operative eyes,and one eye of them presented a long lasting melting of superficial stroma.Four AlphaCor keratoprosthesis were in situ after the surgery of stage Ⅱ except one rabbit died from the anaesthesia during the stage Ⅱ surgery.Corneal perforation caused by inflammatory response occurred in 1 eye at 6 weeks after the surgery of stage Ⅱ,and the proliferating membrane overlying the keratoprosthesis was seen in 3 eyes during the duration of 4-6 weeks.The histologic examination showed that fibrocytes grew into the AlphaCor skirt but no retroprosthetic membrane and calcium deposit was found in the central optic zone.The hematoxylin and eosin staining revealed that the inflammation response was limited in the anterior segment of the eye.ConclusionAlphaCor keratoprosthesis has good biocompatibility.A satisfactory clinical outcome is obtained by AlphaCor keratoprosthesis implantation to cure the alkali-burned cornea in rabbit.