胶原性眼内接触镜植入兔眼术后细胞学反应

A study of the cellular response in the anterior segment of the eye to the surface of the collagen intraocular contact lens after ICL implantation in rabbit eyes

目的 :通过观察以胶原材料为主体的ICL植入兔眼内后的组织细胞学反应 ,评定胶原的生物相容性。方法 :2 0只新西兰白兔 ,被分为ICL植入组、手术对照组和空白对照组。分别于术后第 14天和第 2 8天 ,切取每个眼的前段组织和ICL。脱水固定后 ,采用HE染色光镜及透射、扫描电镜技术进行ICL表面和眼前段组织细胞形态学检查。结果 :ICL植入组在术后早期眼前段组织中以大量吞噬细胞浸润为主 ,巨噬细胞功能活跃 ,成纤维细胞较少。后期巨噬细胞数量减少 ,成纤维细胞增多。手术对照组在术后早期眼前段组织中有较多巨噬细胞存在 ,后期成纤维细胞显著增多 ,且有纤维组织形成。结论 :ICL植入术后 ,炎症细胞变化情况显示为典型的异物肉芽肿性炎症过程。

Objective:To observe the cellular response arising from the collagen intraocular contact lens(ICL) after lens implantation in rabbit's eyes and evaluate biocompatibility of collagen by performing animal experiment.Methods:20 adult rabbits from New Zealand were divided into three groups:①ICL implantation group,carried out ICL implantation and peripheral iridectomy.②Surgical control group,merely performed peripheral iridectomy.③Blank control group,not performed any surgery. On the 14th and 28th days after surgery,the experiment rabbits were killed and their eyeballs were extracted. Then the anterior segment tissue and and ICL were taken out. After dehydration and fixation with HE staining,light microscopy and transmission and scanning electron microscopy were used to investigate cell morphologic changes on the ICL surface and the anterior tissue of the eye following surgical treatment.Results:In the ICL implant group,a large number of macrophages infiltrated on ICL's surface and ocular anterior segment including iris,ciliary body,anterior capsula of lenses;while fibroblast cells and neutrocytes were fewer in the early postoperative stage. Eosinophiles were seen occasionally. The surface of anterior lenses' capsula attached by mononuclears and macrophages chiefly. The epithelia of ciliary body arranged in good order. The endothelia of blood capillary swelled evidently. A lot of lysosome phagocytic particles were in the cytoplasm of macrophages. The epithelia of lenses distributed tidily and the cell apparatus were not abnormal. Late fibroblast cells proliferate. the proportion of foreign-body giant cells and epithelium-like cells went up. Macrophages and lymphocytes were fond on the surface of anterior lenses capsula. In addition,it was seen that mononuclear phagocytes heaped up. In the meantime fibroblast cells and many collagenous fibers adhered to the ICL's surface. The number of macrophages decreased,some of them manifested the changes of early cytonecrosis phage. The endothelia of cornea arranged tidily. The number of them did not reduce. The cell apparatus such as chondrosome,endoplasmic reticulum and so on did not swell. In surgical control group,many macrophages existed in ocular anterior tissue during the early stage. In later period fibroblast cells increased and fibrous tissue formed. In blank control group,it showed that the structure of the anterior tis-sue was normal.Conclusion:Changes of inflammatory after ICL implantation show that the inflammatory responses in the anterior tissue of rabbits eyes were mainly characterized by many phagocytes infiltration during early stage postoperatively. The phagocytosis function of macrophages was active. A small number of fibroblast cells appeared. In the late stage macrophages diminished,on the contrary fibroblast cells growed. It reveals a classic foreign-body granulomatous inflammation after ICL implantation. The collagen ICL possesses excellent ocular biocompatibility.