准分子激光屈光性角膜切削术后兔角膜的组织病理学研究

Corneal Epithelial Wound Healing after Excimer Laser Photorefractive Keratectomy:A Histo-pathological Research

目的观察不同手术量准分子激光屈光性角膜切削术(PRK)术后兔角膜上皮的愈合过程。方法21只兔按左眼拟矫正屈光度-15.0D、右眼拟矫正屈光度-5.0D行PRK。术后1d、3d,1周、2周,1个月、3个月、6个月分别取角膜行光镜、电镜观察。结果-5.0D组术后1个月内、-15.0D组术后3个月内见切削区角膜上皮细胞水肿、排列紊乱,新生基底膜内半桥粒也较稀疏;两组术后第2周始切削区角膜上皮细胞层次明显增多,术后第6个月仍未恢复正常,-15.0D组尤为明显。结论PRK术后角膜上皮持续性过度增生,角膜上皮结构和形态恢复正常-5.0D组需要约1个月,-15.0D组需要>3个月。

Objective To investigate the corneal epithelial healing process after photorefractive keratectomy (PRK).Methods PRK was performed on both eyes of21New Zealand white-rabbits.The attempted corrections were-5.0diopters for the right eyes and-15.0diopters for the left.The eyes were enucleated at1d,3d,1weeks,2weeks,1month,3months,6months after surgery.The corneas were prepared for light and transmission electron microscopies.Results During1month postoperatively for the right eyes and3months for the left,the epithelium on the ablated area showed edema ,disorder arrangement with immature basement membrane.Moreover,the cell layers of corneal epithelium become more than normal during the6months after PRK,especially in the-15.0diopters group.Conclusions The corneal epithelium shows persistent hyperplasia after PRK.The morphological disturbance of epithalium after PRK lasts for about 1month in-5.0diopters group,and for more than3months in-15.0diopters one.