Experimental study of trabecular tissue repair for corneal defect in rabbits

AIM:To investigate the mechanism and effect of trabecular tissue repair for corneal defect,and to provide a theoretical basis for its clinical application.METHODS:Trabeculectomy was performed on 40(80 eyes)of 70 New Zealand white rabbits.Take trabecular tissue for backup.Thirty(30 eyes)corneal defect models were made,trabecular tissue was filled in the corneal defect,and the oblique cross stitch was used to suture the corneal laceration and debridement.Anterior segment image and optical coherence tomography(OCT)were performed at the time 1 d,1 wk,1 and 3 mo after the model was made.After the observation,the cornea was to ken and stained with trypanosome blue-alizarin red and the pathological tissue was examined.RESULTS:Observation 1 wk after surgery,the area of corneal defect was edema,but the corneal curvature was basically normal,and the anterior chamber existed under slit lamp.After 3 mo of observation,most corneal defects were repaired in the form of corneal leucoma and corneal macula(73.3%),the filled trabecular tissue gradually became transparent,fused tightly with the corneal tissue,and the corneal curvature was relatively smooth.But in one case,the trabecular planter was partially detached,no serious complications such as corneal laceration occurred after the stitches were removed.CONCLUSION:The trabecular tissue structure is similar to the corneal,and it can be used as a substitute for the corneal tissue defect by providing fiber scaffolds and cell amplification differentiation,and lay a foundation for the second-stage surgical treatment.

Dual-crosslinked regenerative hydrogel for sutureless long-term repair of corneal defect

Corneal transplantation is the most effective clinical treatment for corneal defects,but it requires precise size of donor corneas,surgical sutures,and overcoming other technical challenges.Postoperative patients may suffer graft rejection and complications caused by sutures.Ophthalmic glues that can long-term integrate with the corneal tissue and effectively repair the focal corneal damage are highly desirable.Herein,a hybrid hydrogel consisting of porcine decellularized corneal stroma matrix(pDCSM)and methacrylated hyaluronic acid(HAMA)was developed through a non-competitive dual-crosslinking process.It can be directly filled into corneal defects with various shapes.More importantly,through formation of interpenetrating network and stable amide bonds between the hydrogel and adjacent tissue,the hydrogel manifested excellent adhesion properties to achieve suture-free repair.Meanwhile,the hybrid hydrogel not only preserved bioactive components from pDCSM,but also exhibited cornea-matching transparency,low swelling ratio,slow degradation,and enhanced mechanical properties,which was capable of withstanding superhigh intraocular pressure.The combinatorial hydrogel greatly improved the poor cell adhesion performance of HAMA,supported the viability,proliferation of corneal cells,and preservation of keratocyte phenotype.In a rabbit corneal stromal defect model,the experimental eyes treated with the hybrid hydrogel remained transparent and adhered intimately to the stroma bed with long-term retention,accelerated corneal re-epithelialization and wound healing.Giving the advantages of high bioactivity,low-cost,and good practicality,the dual-crosslinked hybrid hydrogel served effectively for long-term suture-free treatment and tissue regeneration after corneal defect.

Umbilical cord blood serum therapy for the management of persistent corneal epithelial defects

AIM:Toevaluatetheroleofumbilical cord blood serum(CBS) therapy in cases with persistent corneal epithelial defects(PED).METHODS:Sixteen eyes of 14 patients with PED who were resistant to conventional treatment were treated with 20% umbilical cord serum eye drops. Patients were followed-up weekly until epithelization was complete.The collected data included the grade of corneal lesion(Grade I: epithelial defect +superficial vascularization,Grade II: epithelial defect +stromal edema, Grade III:corneal ulcer +stromal melting), the size of epithelial defect(pretreatment, 7th, 14 thand 21stdays of treatment),and follow-up time was evaluated retrospectively.RESULTS:The mean size of epithelial defect on two perpendicular axes was 5.2×4.6-mm2(range: 2.5-8 mm×2.2-9 mm2). Mean duration of treatment was 8.3 ±5wk.CBS therapy was effective in 12 eyes(75%) and ineffective in 4 eyes(25%). The epithelial defects in 4ineffective eyes were healed with amniotic membrane transplantation and tarsorrhaphy. The rate of complete healing was 12.5% by 7d, 25% by 14 d, and 75% by 21 d.The healing time was prolonged in Grade III eyes in comparison to eyes in Grade I or Grade II.CONCLUSION:The results of the current study indicated the safety effectiveness of CBS drops in the management of PED. The grade of disease seems have a role on the healing time.

Corneal epithelial defects following vitreoretinal surgery:incidence and outcomes from the DISCOVER study

AIM:To investigate the incidence,risk factors,clinical course,and outcomes of corneal epithelial defects(CED)following vitreoretinal surgery in a prospective study setting.METHODS:This was a post-hoc analysis of all participants in DISCOVER intraoperative optical coherence tomography study.Subjects with CED 1 d after surgery without intraoperative corneal debridement was defined as the postoperative CED group.Subjects who underwent intraoperative debridement were defined as intraoperative debridement group.Eyes were matched 2:1 with controls(eyes without postoperative CED)for comparative assessment.The primary outcomes were the incidence of CED on postoperative day one and the incidence of required intraoperative debridement.Secondary outcomes included time to defect closure,delayed healing(>2 wk),visual acuity(VA)and presence of scarring at one year and cornea consult.RESULTS:This study included 856 eyes that underwent vitreoretinal surgery.Intraoperative corneal debridement was performed to 61(7.1%)subjects and postoperative CED developed spontaneously in 94(11.0%)subjects.Significant factors associated with postoperative CED included prolonged surgical duration(P=0.003),diabetes mellitus(P=0.04),postoperative ocular hypotension(P<0.001).Prolonged surgical duration was associated with intraoperative debridement.Delayed defect closure time(>2 wk)was associated with corneal scar formation at the end of the 1 y in all epithelial defect subjects(P<0.001).The overall rate of corneal scarring for all eyes undergoing vitrectomy was 1.8%.CONCLUSION:Prolonged duration of surgery is the strongest factor associated with both intraoperative debridement and spontaneous postoperative CED.Delayed defect closure is associated with a greater risk of corneal scarring at one year.The overall rate of corneal scarring following vitrectomy is low at<2%.

Research progress on animal models of corneal epithelial-stromal injury

A corneal epithelial-stromal defect is recognized as a major contributor to corneal scarring.Given the rising prevalence of blindness caused by corneal scarring,increasing attention has been focused on corneal epithelialstromal defects.Currently,the etiology and pathogenesis of these defects remain inadequately understood,necessitating further investigation through experimental research.Various modeling methods exist both domestically and internationally,each with distinct adaptive conditions,advantages,and disadvantages.This review primarily aims to summarize the techniques used to establish optimal animal models of corneal epithelial-stromal injury,including mechanical modeling,chemical alkali burns,post-refractive surgery infections,and genetic engineering.The intention is to provide valuable insights for studying the mechanisms underlying corneal epithelial-stromal injury and the development of corresponding therapeutic interventions.

不同浓度ZKY001滴眼液治疗原发性翼状胬肉切除术后角膜上皮缺损的疗效

目的:探究不同浓度ZKY001滴眼液治疗原发性翼状胬肉切除术后角膜上皮缺损的有效性和安全性。方法:本研究为多中心、随机、双盲、安慰剂对照的Ⅱ期临床研究。选取2022-03-15/11-14全国12家三甲医院原发性翼状胬肉术后患者,采用区组随机化的方法按照1∶1∶1比例将患者178例178眼随机分为三组:安慰剂组(给予ZKY001模拟滴眼液治疗)60例60眼,0.002%ZKY001滴眼液组59例59眼,0.004%ZKY001滴眼液组59例59眼。各组患者接受研究药物每次1滴,每天4次,使用4 d。观察各组患者在不同时间点的角膜上皮缺损面积较基线改善百分比,角膜上皮缺损区首次完全愈合时间,角膜上皮缺损首次愈合人数,眼部不适(眼痛、异物感、畏光、流泪)等视觉模拟量表评分变化。结果:三组患者角膜上皮缺损首次愈合时间、在不同的随访点三组角膜上皮缺损面积较基线改善百分比、首次愈合人数百分比均无差异(均P>0.05)。但从数值上看,0.002%ZKY001组(67.87±21.688 h)、0.004%ZKY001组(61.48±22.091 h)角膜上皮缺损首次愈合时间较安慰剂组短(68.85±20.851 h)。在D1上午,0.004%ZKY001滴眼液组的角膜缺损面积较基线改善的百分比与安慰剂组的数值差值达到最大,且在后续的随访点保持着数值差值的优势。试验组在不同随访点的角膜上皮缺损区首次愈合人数较安慰剂组多。眼部不适改善方面:试验组较安慰剂组的VAS评分总分值降低多,以异物感评分、疼痛感评分降低为主,在D3时0.004%ZKY001滴眼液组对异物感的改善明显优于其他两组(P<0.017)。安全性方面:总体不良事件发生率低(9.0%),且三组间相似。结论:原发性翼状胬肉术后使用ZKY001滴眼液可改善角膜上皮缺损修复,改善术后因角膜上皮缺损引起的不适症状且安全性良好。

自体血清点眼对神经营养性角膜病变持续角膜上皮缺损的疗效评估

目的评估自制自体血清滴眼液对神经营养性角膜病变(NK)持续角膜上皮缺损的治疗效果。方法采用系列病例观察研究方法,纳入2020年1月至2021年1月于首都医科大学附属北京同仁医院诊断为NK导致的持续性角膜上皮缺损患者20例20眼,按照病变严重程度将患眼分级,采用自制自体血清滴眼液为主的综合治疗,记录角膜上皮愈合时间。采用角膜荧光素染色法标记缺损的直径和面积,10倍裂隙灯显微镜下测量治疗前及治疗后1、2、3、4、8周角膜缺损直径和面积变化;采用标准对数视力表测定患眼治疗前及治疗后1、2、4、12和24周LogMAR视力改变;采用激光扫描共聚焦显微镜和Cochet-Bonnet角膜知觉计分别检查患眼治疗前及治疗后4、12、24周角膜神经纤维分布变化及角膜知觉丝线长度。采用多重线性回归分析评估基线角膜缺损特征对上皮愈合时间的影响。结果治疗前角膜缺损范围直径为5.00(4.00,5.75)mm,缺损面积为15.50(12.00,20.00)mm2。伴角膜基质水肿者占45%(9/20),伴内皮皱褶者占35%(7/20)。除1例糖尿病伴葡萄膜炎患者治疗前角膜溃疡面积较大(8 mm×6 mm),自体血清滴眼液治疗2周效果不明显,联合角膜清创+羊膜移植手术覆盖缺损之后继续用自体血清滴眼液治疗外,其余19例均以自体血清滴眼液治疗为主,20例患者全部治愈。自体血清滴眼液治疗前时程为2周~3个月,平均(39.55±25.34)d。角膜上皮修复时间为12~42 d,平均(19.68±9.25)d。自体血清滴眼液使用前后各时间点角膜缺损面积和直径总体比较差异均有统计学意义(χ2=43.130、28.265,均P<0.001),其中治疗后不同时间点角膜上皮缺损面积和直径均小于治疗前,差异均有统计学意义(均P<0.05)。自体血清点眼前后不同时间点LogMAR视力总体比较差异有统计学意义(χ2=84.229,P<0.001),其中自体血清点眼1、2、4、12和24周患眼LogMAR视力均优于治疗前,差异均有统计学意义(均P<0.05)。自体血清滴眼液使用前后各时间点角膜知觉丝线长度总体比较差异有统计学意义(χ2=55.295,P<0.001),其中自体血清点眼4、12和24周角膜知觉丝线长度均长于治疗前,差异均有统计学意义(均P<0.05)。治疗前角膜缺损严重程度分级对愈合时间的影响有统计学意义(β=10.55,P=0.032),角膜缺损直径和角膜缺损面积对愈合时间的影响均无统计学意义(β=-2.02,P=0.501;β=0.49,P=0.199)。结论以自体血清滴眼液为主的治疗对NK导致的顽固角膜缺损安全有效。停止血清治疗后个别患者角膜缺损复发,再次使用后仍有效。疑难病例可联合手术治疗。

神经营养性角膜炎诊治的研究进展

神经营养性角膜炎(NK)是由三叉神经支配受损引起的退行性角膜疾病,可导致自发性角膜上皮破裂、角膜溃疡甚至穿孔。诸多破坏三叉神经支配的疾病均可导致NK。NK的早期诊断十分重要,需要准确收集和审查患者病史并进行完善的眼表检查,从而确定临床分期。NK的治疗需基于疾病严重程度进行分期治疗,除了人工泪液、睑裂缝合术、羊膜移植术等传统的内外科疗法,目前还有如靶向药物治疗和角膜神经化手术等新兴疗法。本文总结了NK的流行病学、临床表现及分类、病因、诊断、鉴别诊断及治疗,旨在为未来早期诊断和分期治疗NK提供参考。

The inflammation influence on corneal surface after frontalis suspension surgery

AIM： To study the influence of frontalis muscle flap suspension on ocular surface by analyzing the clinical features and inflammatory cytokines.METHODS： A prospective, observational case series. Thirty-one eyes of 25 patients with severe congenital blepharoptosis who underwent frontalis muscle flap suspension surgery with at least 6 mo of follow-up were included in the study. The main outcome measures were margin reflex distance 1（MRD_1）, degree of lagophthalmos, ocular surface disease index（OSDI）, fluorescein staining（Fl）, tear break-up time（BUT）, Schirmer I test, and inflammatory cytokine assay.RESULTS： The degrees of lagophthalmos significantly increased after surgery. The OSDI scores significantly increased 1wk postoperatively and then decreased 4wk after operation. The Fl scores reflected corneal epithelial defects in sixteen patients at early stage postoperatively. The BUT and Schirmer I test values remained stable and did not show change compared to those before surgery. The inflammatory cytokines in conjunctival epithelial cells（including IL-1β, IL-6, IL-8, TNF-α, and IL-17A） significantly increased 1wk after the surgery（P〈0.001）, then returned to the normal level at 24wk postoperatively. The levels of inflammatory cytokine IL-1β, IL-6, IL-8, TNF-α, and IL-17A elevated significantly and were positively correlated with OSDI and Fl scores.CONCLUSION： Frontalis muscle flap suspension surgery results in lagophthalmos in early period of post-operation and relieved after months. The elevation of inflammatory cytokines level may participate in the occurrence of corneal epithelial defects at the early postoperative stage.

干眼角膜上皮损伤患者患病率和危险因素的回顾性研究

目的:探究干眼角膜上皮损伤患者的流行病学特征及相关危险因素。方法:回顾2018-07/2019-06期间就诊于北京大学第三医院的干眼角膜上皮损伤患者的门诊病历,对患者性别、年龄、就诊日期、合并症以及同一时期的气象指标进行统计学分析。结果:回顾性分析291名干眼角膜上皮损伤患者,其中有75.3%为女性。21-30岁的青年患者占比最大(26.5%),青少年(<18岁,5.8%)和老年人(≥61岁,17.2%)较少。然而,中青年患者虽然占比较大,其平均就诊次数较少(5.4±12.4)。春季和冬季是最主要的就诊季节。分析表明,PM_(10)、二氧化硫(SO_(2))、二氧化氮(NO_(2))、以及较低的平均相对湿度与干眼角膜上皮损伤显著相关(P<0.05)。结膜炎、白内障、视物模糊以及倒睫是排名前四位的合并症。结论:女性、青年人群干眼角膜上皮损伤问题不容忽视。PM_(10)、SO_(2)、NO_(2)和空气湿度降低与干眼角膜上皮损伤显著相关。对于合并有结膜炎、白内障、视物模糊以及倒睫的干眼患者,更应关注其角膜状况。

白内障术后角膜切口缺陷及其影响因素研究进展

透明角膜切口(CCI)是目前临床上应用范围最广的白内障手术切口。CCI表面没有结膜覆盖,其自身的密闭性是保证手术安全,防止眼内感染的关键因素。正常情况下,CCI在手术后很快就会密闭,但是在手术结束移除开睑器或术后用力挤压眼睑时,CCI的密闭性可能会受到破坏。前段光学相干断层扫描(AS-OCT)因其具有非接触性、分辨率高等特点,是目前观察角膜切口最理想的方法。CCI自身的大小、构型,手术过程中机械性损伤、热损伤,CCI闭合的方式,术后眼压等因素均会影响CCI的愈合。本文就白内障术后角膜切口缺陷及其影响因素进行综述,以供眼科医师在临床工作中参考。

经上皮准分子激光角膜切削术后角膜上皮延迟愈合1例

目的探讨经上皮准分子激光角膜切削术(TPRK)术后角膜上皮延迟愈合原因及治疗。方法回顾性分析1例青年女性因近视行TPRK后出现角膜上皮延迟愈合的临床资料。结果角膜上皮延迟愈合是TPRK术后早期少见并发症。本例患者因TPRK术后角膜上皮延迟愈合出现眼部疼痛、视物模糊、眩光流泪等症状。长期配戴隐形眼镜、睑板腺功能障碍及术后使用抑制上皮生长药物是其危险因素,患者经过配戴绷带镜、玻璃酸钠滴眼液、小牛血去蛋白提取物眼用凝胶、糖皮质激素、更昔洛韦眼用凝胶、角膜上皮清创刮除术等综合治疗22 d后,角膜上皮完全愈合,延迟愈合区域角膜上皮下雾状混浊1级,半年后角膜透明无浑浊。结论对具有TPRK术后角膜延迟愈合危险因素的患者,术前应进行全面检查以减少角膜上皮延迟愈合风险;当出现术后角膜上皮延迟愈合时应及早进行综合治疗,警惕角膜上皮下雾状混浊和单纯疱疹病毒感染。

r-bFGF联合妥布霉素治疗外伤性角膜上皮缺损及对患者生长因子、sICAM-1、HMGB1、TXNIP水平的影响

目的观察重组牛碱性成纤维细胞生长因子(r-bFGF)联合妥布霉素治疗外伤性角膜上皮缺损及对患者生长因子、可溶性细胞间粘附分子1(sICAM-1)、高迁移率族蛋白B1(HMGB1)、硫氧还蛋白互作蛋白(TXNIP)水平的影响。方法纳入我院2016年5月至2021年2月门诊就诊的外伤性角膜上皮缺损患者160例,根据信封抽签法分为对照组80例和观察组80例,对照组患者予以妥布霉素治疗,观察组在对照组的基础上联合r-bFGF治疗,对比两组疗效、眼表症状指标、泪液细胞因子、角膜上皮愈合时间、生长因子水平、炎症因子水平,观察两组用药不良反应发生情况。结果观察组的临床总有效率高于对照组(P<0.05)。治疗2周后,观察组泪液分泌时间(TST)、泪膜破裂时间(BUT)高于对照组,眼表疾病指数(OSDI)、角膜荧光染色(FL)低于对照组(P<0.05)。治疗2周后,观察组患者血管内皮生长因子受体1(VEGFR1)、表皮生长因子(EGFR)、血清成纤维细胞生长因子23(FGF-23)均高于对照组(P<0.05)。治疗2周后,观察组患者sICAM-1、HMGB1、TXNIP均低于对照组(P<0.05)。观察组的角膜上皮的愈合时间明显短于对照组(P<0.05)。两组患者均未见明显的不良反应发生情况。结论r-bFGF联合妥布霉素治疗外伤性角膜上皮缺损,可促进症状改善,缩短角膜上皮的愈合时间,同时还可有效降低泪液炎症因子水平,提高患者的生长因子水平,具有较好的临床应用价值。

厄洛替尼在眼表的并发症:3个病例不同转归

目的 报道3例表皮生长因子受体抑制剂厄洛替尼眼表并发症患者的临床资料,并分析3个病例不同转归的原因。方法 病例系列报道。结果 病例1患者口服厄洛替尼近7年,眼部检查发现双眼角膜点状上皮脱落,未停用靶向药物而仅眼部用药后角膜上皮修复。病例2患者使用厄洛替尼2年余,单眼出现无菌性角膜溃疡伴角膜基质变薄,患眼接受多层羊膜移植同时停用厄洛替尼1周后,缺损的角膜上皮逐渐愈合。这2例患者全身除肺癌病史外,均无高血压、糖尿病及自身免疫性疾病等病史。病例3患者除了肺癌,还有明确的干燥综合征病史,在接受厄洛替尼治疗2年余后,眼表出现严重并发症,包括持续性角膜上皮缺损、角膜溶解和穿孔,并且进行了4次穿透性角膜移植术。停用厄洛替尼后眼表才逐渐趋于稳定。结论 在使用表皮生长因子受体抑制剂之前,需进行详细的眼部检查,排除眼表基础疾病,尤其是自身免疫性眼表疾病。同时,患者在使用此类药物期间需定期接受眼科随访,以避免眼表严重并发症的出现。

羊膜填塞联合前房C_3F_8注气术治疗外伤性角膜穿孔

目的:探讨羊膜填塞联合前房C3F8注气术治疗外伤性角膜缺损并穿孔的疗效。方法:应用甘油冷冻保存羊膜制作成羊膜卷,对5例外伤性角膜缺损并穿孔患者行羊膜填塞联合前房C3F8注气术治疗。结果:术后前房形成好,羊膜卷无脱出或脱入前房,角膜缺损逐渐愈合。视力均得到提高,术前视力均小于0.1,术后3mo时,有3例视力>0.5,1例0.3,1例0.08。结论:羊膜填塞联合前房C3F8注气术治疗外伤性角膜缺损并穿孔是一种简便易行,疗效较好的治疗方法。

玻璃体切割术后持续性角膜上皮缺损的诊治探讨

目的:总结、探讨玻璃体切割术后并发持续性角膜上皮缺损的诊治经验。方法:对玻璃体切割术后并发持续性角膜上皮缺损的10例11眼进行三联或四联治疗,即停止原有术后抗炎眼药水点眼、促进角膜修复眼药水点眼、球周适量激素应用及临时性睑裂缝合术治疗,观察角膜病变修复的情况,并统计持续性角膜上皮缺损的发生率。结果:玻璃体切割术后并发持续性角膜上皮缺损发生率为2.2%(11/509),其中糖尿病性视网膜病变玻璃体切割术后并发持续性角膜上皮缺损发生率为4.8%(8/165),治疗后全部愈合(100%),病程2～6wk,遗留角膜云翳者5眼(45.5%)。结论:玻璃体切割术后并发持续性角膜上皮缺损,是多因素作用的结果,其中糖尿病患者高发值得重视。终止药物毒性作用、加强角膜营养以及必要时的临时性睑裂缝合术是有效的治疗方式。

昏迷患者角膜病变危险因素分析

目的评估昏迷患者角膜病变的发生状况并分析其危险因素,为临床专科护理实践策略的发展提供依据。方法采用研究对象情况调查问卷并借助荧光染色和便携式裂隙灯对重症监护室的102例昏迷患者进行测评和分析。结果昏迷患者角膜上皮脱落的发生率达12.7%。眼睑闭合不全、镇静剂的使用、瞳孔检查的间隔时间是发生角膜病变的危险因素(均P<0.05)。结论昏迷患者有较高的角膜病变发生率,尤其是眼睑闭合不全和使用镇静剂的患者,以预防为主的眼部护理应成为重症护理的必要组成部分。

部分永久性睑缘缝合术治疗持续性角膜上皮缺损27例

目的探讨部分永久性睑缘缝合术治疗持续性角膜上皮缺损的临床疗效。方法回顾分析2004年1月至2007年4月于山东省眼科医院行部分永久性睑缘缝合术治疗的持续性角膜上皮缺损患者27例(27眼)。27眼角膜上皮缺损持续时间均超过7d,其中,板层角膜移植术后植片上皮缺损11眼,穿透性角膜移植术后植片上皮缺损10眼,热烧伤及化学伤角膜上皮缺损4眼,暴露性角膜炎角膜上皮缺损2眼,所有患者均经药物、羊膜移植或角膜缘干细胞移植术等治疗。结果行部分永久性睑缘缝合术后,荧光素钠染色显示角膜上皮愈合情况,除1眼外,26眼角膜上皮完全愈合,治愈率为96.3%,愈合时间为术后3～14d,平均为6d。除2眼睑缘愈着处患者自行挣裂外,余眼睑切口接合处愈合良好,无其他并发症发生。结论对于单纯应用药物、羊膜移植或角膜缘干细胞移植术等不能控制的持续性角膜上皮缺损,行部分永久性睑缘缝合术,可以达到治愈的效果。

兔角膜碱烧伤后角膜基质注射脐带间充质干细胞的疗效

目的观察角膜基质注射脐带间充质干细胞(umbilicalcord mesenchymal stem cells,UMSCs)治疗兔角膜碱烧伤的效果。方法健康新西兰大白兔随机分为3组,每组12只,每只兔左眼为角膜碱烧伤模型眼。A组兔左眼在碱烧伤2 d后角膜基质内注射含有2×106个UMSCs的磷酸盐缓冲液2μL,B组注射相同剂量的磷酸盐缓冲液,C组为角膜碱烧伤后未进行处理组,在注射后不同时间对角膜混浊程度、新生血管生长情况、角膜上皮缺损情况等进行临床观察并评分,同时进行综合评分。结果注射后14 d A组新生血管生长较B组明显缓慢,A组、B组注射隧道周围角膜新生血管生长评分分别为0分、2分,差异有统计学意义(P<0.05)。注射后2 d和6 d A组角膜混浊程度较B组明显轻,注射后2 d A组、B组角膜混浊程度评分分别为2分、4分,注射后6 d评分与2 d相同,差异均具有统计学意义(均为P<0.05)。注射后2 d、7 d角膜上皮荧光素染色评分各组之间差异均无统学意义(均为P>0.05)。结论碱烧伤后角膜基质注射UMSCs可减少新生血管的形成,为抑制碱烧伤后角膜血管化提供参考,碱烧伤后角膜基质注射UMSCs可在一定程度上恢复角膜透明度。

创伤性眼角膜缺损的角膜移植治疗

目的探讨创伤性眼角膜缺损的角膜移植治疗的效果及相关危险因素。方法应用同种异体角膜对创伤性眼角膜缺损进行角膜移植,采用10-0显微尼龙细线进行严密间断或连续缝合,观察其术后透明度、角膜排斥反应、视力、眼压等指标。结果术后植片存活良好、前房形成良好;24例中,有6例产生角膜排斥反应,6例眼压升高,5例产生新生血管。24例视力均提高,均有不同程度散光。结论创伤性眼角膜缺损采用角膜移植是直接有效的治疗手段,术中要仔细严密缝合,术后影响视力的危险因素是角膜免疫排斥反应、继发性青光眼和角膜新生血管。