后板层角膜移植治疗大泡性角膜病变的动物实验研究

Experimental study on posterior lamdllar transplantation for treatment of bullous keratopathy in animals.

目的 探讨后板层角膜移植术治疗大泡性角膜病变的可行性。 方法 建立大泡性角膜病变动物实验模型。设实验组和对照组 :实验组 6只兔在模型建立后 1周对 6只眼进行后板层角膜移植术 ,术后每日观察结膜充血、角膜水肿和新生血管生长情况 ,于术后 3月摄像记录 ,取角膜做病理切片检查。对照组 6例同样建立模型 ,在实验结束时亦取角膜进行病理切片检查。 结果 实验组 :角膜植片成活 ,裸眼观透明。状况评价为 0级 4眼 ;1级 2眼。病病切片示基质层胶原纤维平行于角膜表面排列 ,前板层自体角膜胶原纤维排列紧密 ,移植的后板层胶原纤维排列疏松。对照组 :角膜混浊 ,基质浅层见精大、明显的新生血管长入。角膜状况评价为 3级 1眼、4级 2眼 ;病理切片示全角膜厚度为正常的 2倍 ,角膜基质浅层出现新生血管 ,平行于角膜表面 ,上皮增生 ,有淋巴细胞浸润 ,上皮细胞增殖、排列紊乱。 结论 后板层角膜移植术是一种新的。

Objective To test the feasibility of posterior lamellar transplantaion(PLT) for treatment of bullous keratopathy(BK). Methods The BK models of twelve pigmented rabbits were produced by getting rid of endothilium cells. Tested group:a week later 6 rabbits with BK model undrwent a surgical procedure including removal of the corneal posterior lamella,creation of a 10mm corneal flap,substitution of an underlying 9mm button of deep stroma and endothelium with a 9.5mm donor button, and suturing of the flap back into position using a 11～0 running nylon suture.Control group rabbits were built into the BK models as well, without receiving other operation.Histomorphological observation was performed by light microscopy after completion of the experiment. Results The corneas allografts of rabbits(tested group)show clear without vascularization(4 rabbits)and the others displayed a slight growing new blood vascular at corneal limbus and bulge.Histomorphological observation showed lamellae of collagenous fiber bundles in very regular arrangement,parallel to the corneal surface.while corneal posterior lamella collagenoous fiber bundles were less denser than front. In comparison,rabbits of control group had corneal opacity,bullous keratopathy and some great new blood vessel grew into the anterior cornea. The corneal stromal layer was spoiled and infiltrated with lymphatic cells. Conclusion Posterior lamellar transplantation may continue to gain interest as alternative procedures for a penetration keratoplasty in the treatment of bullous keraopathy.