垂直弹射对LASIK术后兔角膜瓣稳定性的影响

Effects of vertical acceleration on stability of corneal flap after LASIK in rabbits

目的研究垂直弹射对准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)后兔角膜瓣稳定性的影响。方法将12只日本大耳白兔双眼行LASIK,术后1周随机分2组,一组为对照组,未行任何刺激;另一组为垂直弹射组,弹射模拟器的弹射高度为5 m,垂直加速度为+7 G,反复10次。用光镜和透射电镜观察兔角膜瓣结构的变化,并比较两组角膜瓣的稳定性。结果光镜观察:弹射后角膜基质愈合线清晰,未见分离,部分基底细胞呈空泡样变性,胶原排列轻微紊乱。透射电镜观察:伤口对合紧密,周围组织修复均匀,创口两侧角膜纤维组织排列规则,未见层间分离。兔角膜瓣稳定性比较:弹射组与对照组,未见统计学差异(P=0.64)。结论 LASIK术后1周,垂直弹射10次观察兔角膜瓣稳定。

Objective To study the stability of the laser in situ keratomileusis （LASIK） flap in a rabbit model when subjected to vertical acceleration at ten times the force of gravity （＋7Gz）. Methods It was an experimental study. 24 eyes（12 Japanese white rabbits） with one week postoperative LASIK were randomly divided into 2 groups： the control group without any simulator; the vertical accelerated group which underwent a controlled rapid-sequence ejection at ＋7 Gz. in a cockpit ejection seat simulator. The stability of corneal flap was observed with optical microscope and transmission electron microscope （TEM）. The stability of corneal flap was compared between the groups. Results The images under optical microscope and TEM showed that the interface tissue healing between the flap and stromal bed was clear without separation, and surrounded by regular collagen fibers in vertical accelerated group. The differences between the two groups was insignificant（P=0.64）.Conclusions When subjected to a rapid vertical ejection at ten times the force of gravity, corneal flaps after LASIK in rabbit model are stable.