自体角膜缘移植治疗兔单眼碱烧伤的实验研究

Autologous limbal autograft for alkali-burned corneas in rabbit:an experimental study

目的探讨角膜碱烧伤后行自体角膜缘移植术的疗效,并评估其对健康眼的影响。方法在32只兔右眼上制作碱烧伤模型,烧伤1周后行自体角膜缘移植,作1/4、1/2、3/4周和全周范围移植者各8只,术后4周观察疗效。结果作全周自体角膜缘移植的8只兔患眼全部恢复正常眼表,作3/4、1/2、1/4周移植的患眼分别有87.5%(7/8)、37.5%(3/8)和0.00%恢复正常眼表;而作全周切取角膜缘的8只供眼均未恢复正常眼表(100%),角膜糜烂,有新生血管和假性胬肉长入,而切取3/4、1/2周角膜缘的供眼分别有75%(6/8)和12.5%(1/8)未恢复正常,切取1/4周角膜缘的供眼均恢复正常。结论行自体角膜缘移植可有效地治疗眼碱性烧伤,可作临床推广,但要注意供体眼取材范围不宜超过1/2范围,以免损伤健康眼。

Objective To evaluate the effect of autologous limbal transplantation in the treatment of alkali-burned corneas in rabbits and assess the possible influence of this operation on the donor eye. Methods Animal models of alkali-burned corneas of the right eye were established in 32 rabbits, and 7 days after the injury, transplantations of the corneal limbal stem cells were per- formed, with the transplanted limbal coverage of the whole, 3/4, 1/2 and 1/4 of the recipient limbal circumference respectively. Results Four weeks after the operation, all the 8 recipient eyes with whole circumference limbal autografting recovered normal sight, while in those receiving 3/4, 1/2 and 1/4 circumference transplatation, 87.5%(7/8), 37.5%(3/8) and 0.00% (0 of 8) attained the recovery, respectively. The donor eyes with wholly circumferential resection of the limbal all had epithelial erosion, pseudopterygium lesions and neovascularization, and among those with 3/4 and 1/2 exsection, 75%(6/8) and 12.5%(1/8) developed the lesions, while 1/4 exsection did not affect the final healing of the donor eyes. Conclusion Corneal limbal stem cells autografting is effective for treating alkali-burned corneas, but no more than 1/2 circumference resection of the donor cornea is recommended for the smooth healing of the donor eye after the operation.