激光角膜屈光手术后的神经修复

Corneal nerve regeneration after laser refractive surgery

干眼症是激光角膜屈光手术后常见的并发症之一,与角膜神经损伤密切相关。角膜神经损伤修复缓慢,术后6个月仍未恢复至术前水平。不同的激光角膜屈光手术带来的神经损伤亦不相同。角膜神经修复涉及角膜细胞分泌细胞因子、角膜细胞的分化、角膜缘血管内淋巴细胞和巨噬细胞的迁移、角膜中心部基质下神经丛中性粒细胞的迁移及其生长因子的分泌等复杂过程。一些细胞因子、信号素、自体血清等参与角膜神经的修复,但目前多为动物实验,临床研究较少。

Dry eye disease is one of the most common complications after refractive surgery,which is highly associated with the postoperative corneal nerve damage.The regeneration of corneal nerve is a slow process.It was showed that even 6 months after surgery,the morphological characteristics of corneal nerve still could not reach the pre-operation level.The damage to the corneal nerve varies among different refractive surgeries.The mechanism of corneal nerve regeneration involve the cytokines secreted by keratocytes,the differentiation of keratocytes,the migration of lymphocytes and macrophages within the limbal vessels,the migration of neutrophils in the central corneal nerve plexus and the secretion of growth factors,etc.Some cytokines,semaphorin and autologus serum take part in this regenerating process.However,research on this topic were mostly animal experiment.Few of them were clinical researches.