家兔PRK术后角膜创面的免疫组织化学研究AIM

A IMMUNOHISTOCHEMICAL STUDY OF RABBIT CORNEA AFTER EXCIMER LASER PHOTOREFRACTIVE KERATECTOMY

目的 评价实验性家兔不同屈光度PRK术后角膜创面愈合的过程。方法 应用SVSAPEXPLUS型 (SummitTechnologyInc.USA)准分子激光治疗系统对 6只家兔双眼进行PRK术 ,随机分为FLM点眼组和CM点眼组 ,每组 3只家兔 ,分别于术后 3d、30d、10 0d两组随机选取 1只家兔 ,猝死摘除双眼球 ,取其角膜。OCT包埋后冰冻切片 ,用于免疫组化研究 ,检测Ⅲ -C和FN。结果 所有家兔角膜上皮均在PRK术后第 3天愈合 ,术后 15d开始出现不同程度的角膜haze ,30～ 60d的最明显 ,术后 10 0d ,除 1只家兔角膜haze为 1级外 ,余家兔角膜haze为 0级。CM组Ⅲ -C和FN的表达较FLM组明显 ;左眼 (- 8 0 0D)Ⅲ -C和FN的表达较右眼 (-4 0 0D)明显。结论 PRK术后 10 0d角膜组织结构基本正常 ,但仍有组织薄弱处和特殊性改变。角膜基质层切削深度可能是影响PRK术后haze发生的一个因素。

Objective To evaluate the corneal healing of non-equality diopter response immunohistochemical after excimer laser photorefractive keratectomy(PRK) with SVS APEX PLUS excimer laser,Methods PRK was operated on both eyes of 6 white rabbits(12 eyes).They divided the the patients into 2 groups according to the randomization:group FLM(3 white rabbits,6 eyes)and group CM(3 white rabbits,6 eyes).At 10d,30d and 100d the eyes were reexamined.At random,the eyes of one rabbit (group FLM and group CM)were enucleated. Cornea was prepared in OCT compound for immunohistochemical study to examine Ⅲ-C and FN.Results All eyes were reepithelialized within 3d after PRK.Subepithelial corneal haze was observed in 15d which was not dominant in 30 or 60d.In 100d of postoperatively,11 eyes or the corneal naze ws grade 0 or 0.5.Only one eye(the left eye of group CM)showed denser haze,grade 1 was observed in one eye at 100d.The expression of Ⅲ-C and FN were in group CM was significantly more than that in group FLM.Conclusion We found that despite recovery of a continuous and smooth epithelial layer and near normal corneal tissues 100d after PRK,abnormalitiesof both epithelium and superficial stroma could be detected in the area of ablation.The ablation depth of stroma can influence the appearanceof corneal haze after PRK.