皮质类固醇与非甾体抗炎药物对兔眼LASIK术后角膜超微结构的影响

Ultrastructural pathological alterations of corneal organization by local application of corticosteroid and NSAIDs in rabbits

目的观察兔LASIK后应用皮质类固醇或非甾体类药物的角膜超微病理学改变。方法对36只兔建立右眼LASIK模型，并随机分3组：A组为0．1％氟米龙滴眼液干预组；B组为普拉洛芬滴眼液干预组；C组为对照组。术后3天、1月、3月于3组分别取4只兔处死后取角膜组织处理，行光镜及透射电镜检查。结果光镜：术后早期，C组上皮细胞的增生较A、B组明显，前基质胶原纤维排列较后两组紊乱；透射电镜：B组术后早期上皮表层细胞出现凋亡、脱落。指状突起结构显著减少，上皮细胞内胞质疏松，线粒体水肿。A组上皮内出现类似改变，但较轻微。结论皮质类固醇及非甾体类药物均可抑制LASIK术后兔角膜上皮细胞、前基质胶原纤维的增殖；前者作用略强且角膜上皮毒性较轻。

Objective To observe the ultrastructural pathological alterations of cornea after LASIK by local using corticosteroid and NSAIDs in rabbits. Methods LASIK was performed in right eye of 36 rabbits, and were randomly divided into group A （0. I%FML）; group B （NASIDs）. Both groups were dropped 4 times a day and subtracted gradually 1 time every week. Other rabbits were dropped nothing （group C）. Four rabbits of every group were sacrificed and acquired cornea to perform light microscope and electron microscope at 3 days, 1 month, and 3 months after LASIK respectively. Results Light microscope： at early stage after LASIK the proliferation of epithelial of group C was more evident than group A and B, the arrange of collagen fiber was more disorder; Electron microscope： the epithelial surface of group B appeared apoptosis and unhealthy. The finger protrude structure decreased obviously. Cytoplasm of epithelial cells was lost. The expression of group A was weaker than group B. Conclusions Corticosteroid can inhibit the proliferation of corneal epithelial and anterior stroma collagen fiber after LASIK. The function of NSAIDs is weaker Corticosteroid has the lighter epithelial toxicity to cornea than NSAIDs after LASIK.