准分子激光治疗性角膜切削术治疗兔细菌性角膜病变

Study on phototherapeutic keratotomy for bacterial corneal lesions in rabbit

目的:研究准分子激光治疗性角膜切削术(phototherapeutic keratectomy,PTK)对兔眼细菌性角膜溃疡愈合的影响,并探讨该方法用于临床上治疗细菌性角膜病变的可能性。方法:24只新西兰大耳兔48眼接种金黄色葡萄球菌,成功制作细菌性角膜溃疡模型。接种细菌后1～2d溃疡明显形成,予以左氧氟沙星滴眼液滴眼。术前行双眼前节裂隙灯检查,双眼光学相干断层扫描(optical coherence tomography,OCT)检查并测量角膜溃疡中央深度。接种3d后所有实验兔右眼行PTK手术,左眼不予以处理作为对照眼。术后3、7d再行裂隙灯检查,并行OCT检查测量角膜溃疡中央厚度。术后7d处死实验兔,摘除双眼眼球取角膜组织行病理切片观察。结果:经裂隙灯观察,随时间推移两组兔眼角膜溃疡均有愈合倾向,表现为溃疡面积缩小和表面变平坦光滑。观察组术前测量角膜溃疡深度与对照组比较,差异无统计学意义(t=0.706,P=0.484)。观察组术后3、7d角膜溃疡厚度与对照眼比较,差异有统计学意义(P<0.05)。结论:PTK能有效治疗兔眼金黄色葡萄球菌性角膜溃疡,促进溃疡创面愈合,这可能为PTK应用于临床治疗患者细菌性角膜病变提供实验依据。

AIM:To study the effect of phototherapeutic keratectomy(PTK)on rabbit bacterial corneal ulcer model and explore the clinical potential of this method.METHODS:Totally 48 eyes from all the 24 New Zealand rabbits were inoculated with Staphylococcus aureus and bacterial corneal ulcer model was established successfully.At 1d after inoculation,48 eyes were given levofloxacin eye drops when corneal ulcer was confirmed.Then slit lamp inspection and optical coherence tomography(OCT)were performed to measure the central corneal ulcer depth.All the rabbits right eyes were treated with PTK,as an observation group,left eyes were not treated as a control group.The eye section were observed by slit lamp and central thickness of corneal ulcer was measured by OCT at 3 and 7d after this operation.Rabbits were sacrificed and the cornea was removed for pathological section 7d later.RESULTS:The corneal ulcers in both groups had a tendency to heal,showing a decrease in ulcer area and smoothness of the surface.There was no significant difference in the depth of corneal ulcer between the observation group and the control group before PTK(t=0.706,P=0.484).The difference between the two groups of eyes at 3 and 7d after PTK was obviously(P<0.05).CONCLUSION:PTK can effectively cure rabbit Staphylococcus aureus corneal ulcer and promote ulcer wound healing,which may be used for clinical treatment of patients with bacterial corneal lesions.