结膜松弛症球结膜及筋膜组织的超微结构观察

Uitrastructure change of conjunctiva and fascia tissue of conjunctivochalasis

背景结膜松弛症（CCh）手术治疗中观察到球结膜变薄、弹性下降、张力降低，筋膜萎缩；组织病理学检查发现CCh球结膜弹力纤维减少、胶原纤维融解。但目前对CCh球结膜超微结构的研究较少。目的探讨CCh球结膜变薄、筋膜萎缩的发病机制，对CCh和正常球结膜组织进行透射电子显微镜观察。方法收集5例CCh松弛结膜组织为CCh组，5例正常球结膜组织为正常对照组，用透射电子显微镜观察其各层组织超微结构改变。结果CCh组球结膜固有层成纤维细胞数量减少，外形呈长梭形，胞突细长，核一质比增大；胶原原纤维紊乱、分散、断裂，并出现局灶性溶解缺失。CCh组筋膜层成纤维细胞呈线形，胶原原纤维严重缺失。结论CCh患者球结膜固有层及筋膜组织中胶原原纤维减少、成纤维细胞变性。

Background Bulbar conjunctiva tissue appears to be thinning, elasticity declined, tension reduced and fascia atrophied in conjunctivochalasis. Histopathological examination of conjunctivochalasis shows decrease of elastic fibers and melt of collagen fibers. But there are fewer studies on the ultrastructure of conjunetiva of conjunctivochalasis up to now. Objective This study was to investigate the ultrastructure change of eonjunctiva tissue in conjunctivochalasis. Methods Five loose conjunctiva samples of conjunctivochalasis and 5 normal conjunctival tissue samples were collected and uhra-mierostructure changes of these samples were observed under the transmission electron microscope. Results The number of fibroblasts in conjunctivochalasis lamina was progressively decreased. The shape of fibroblasts was long and fusiform. Somatic synapse was slim. Nucleus-cytoplasm ratio was increased. Disorder, scattered and broken of the collagen fibril were seen, and some areas were dissolved or lacunae. Normal conjunctival fibroblasts were oval or polygonal, with wieners and long somatic synapse, and intercellular matrix was full of collagen fibril and dense arranged fibers. Fibroblasts in fascia of conjunctivochalasis were linear,and collagen fibril was seriously defected. Fascia fibroblasts of normal bulbar conjunctiva were spindleshaped and bigger than conjunctivochalasis fibroblasts. There were full of collagen fibrils in intercellular matrix. Conclusions The collagen fibril is decreased and fibroblast cells are degenerated in lamina and fascia of conjunctivochalasis.