显微板层角膜移植术后形态学改变及对角膜透明度的影响

Morphologic changes after microlamellar keratoplasty and its effect on corneal transparency

目的了解显微板层角膜移植术后的组织学改变及对角膜透明度的影响。方法利用光镜、电镜和分光光度计观察了显微板层角膜移植术后不同时间角膜基质的组织学变化、透光率和吸光度,对比观察了显微角膜切削刀和准分子激光切削的角膜剖面形态。结果准分子激光切削的角膜表面有许多变性胶原碎屑。显微角膜切开刀切削的角膜表面光滑,术后1个月,光镜下无明显的瘢痕,透射电镜仅见2～3个角膜板层厚度的界面瘢痕,其下3～4个板层内的角膜细胞有较多伪足,但无炎性细胞浸润。术后1,3个月角膜的透光率和吸光度与未手术角膜比较无显著性差异。结论显微板层角膜移植术后界面瘢痕轻微,不影响角膜透明度。

ObjectiveTo observe the morphologic patterns of corneal stro mal interface after microlamellar kerato plasty(MLK),and to assess its effect on corne al transparency.MethodsThe patterns of interface between corneal recipients an d grafts after MLK were observed by light microscope and electron microscope.Corneal transparency and light absorbency were measured with an op timeter.ResultsUnder scanning electron microscope, there was denatured col lagen chipping on corneal section plane created by excimer laser,but the corneal section plane excised by the microkerat ome was smooth without any chipping.One month later after MLK,there was no stromal scar between t he corneal recipients and grafts under t he light microscope.Transmission electro n microscopy showed that there was a ver y thin stromal scar just about only 2～3 collagen fiber microlayers thickness and the keratocytes of recipient cornea had many pseudopodia in 3～4 collagen fiber microlayers under the corneal section pl ane.There was no significant difference in the corneal transparency and absorben cy between the nonoperative and postoper ative corneas at postoperative 1,3 month s.ConclusionThe results suggest that t he inter stromal scar between corneal re cipients and grafts after MLK is very thin and would not effe ct the corneal transparency.