新鲜羊膜移植治疗角膜溃疡的临床分析

目的探讨新鲜羊膜移植在治疗角膜溃疡中的作用。方法真菌性角膜溃疡5例（5眼），细菌性角膜溃疡9例（9眼），病毒性角膜溃疡4例（4眼），蚕蚀性角膜溃疡2例（2眼），化学烧伤性角膜溃疡6例（8眼），热烫伤性角膜溃疡7例（10眼）。均行新鲜羊膜移植术，相应药物治疗。结果随访6～18月。感染性角膜溃疡17眼愈合，视力均有提高，其中1眼病毒性角膜溃疡愈合后形成角膜瘢痕，视力降低，3眼真菌性角膜溃疡多次新鲜羊膜移植后未愈合，最终行角膜移植；化学性和热烫伤性角膜溃疡愈合时间较长，视力部分恢复，其中4眼病情较重行羊膜移植失败，最后睑裂暂时性缝合1眼，3眼行角膜移植术。结论羊膜移植术是治疗角膜溃疡疗效较好且经济方便的方法之一。对真菌性角膜溃疡治疗效果一般，尚需角膜移植和抗真菌治疗等方法。     

新鲜羊膜移植术对角膜新生血管抑制作用的实验研究

目的探讨新鲜羊膜移植术对角膜碱烧伤后角膜新生血管和上皮愈合作用的影响,并与保存羊膜作比较.方法用48只新西兰大白兔制作角膜碱烧伤模型,烧伤后48h设立新鲜羊膜移植组(fAMT)、保存羊膜移植组(pAMT)和对照组(C).术后每日观察角膜新生血管和上皮愈合情况.并于术后14、30d以计算机图像分析系统定量测定新生血管和上皮愈合面积.结果术后30dfAMT组、pAMT组、C组角膜新生血管面积分别为87.87mm2±3.57mm2、96.66mm2±12.00mm2、105.13mm2±6.70mm2.统计分析显示,fAMT组角膜新生血管面积小于pAMT组(P＜0.05),上述2组均小于C组(P＜0.05).结论新鲜羊膜移植术可抑制碱烧伤后角膜新生血管生长,其作用优于保存羊膜移植术.     

组织工程角膜片移植治疗无菌性角膜溃疡的实验研究

目的探讨组织工程角膜片治疗角膜溃疡的可行性及疗效。方法将16只新西兰大白兔制作成角膜溃疡模型,随机分为2组,每组8只,分别作单纯羊膜移植和以羊膜为载体的组织工程角膜片移植。术后进行大体观察、裂隙灯观察、组织学观察、扫描电镜观察。结果羊膜为载体组织工程角膜片移植治疗角膜溃疡,平均7.5周溃疡完全愈合,角膜恢复透明性和屈光性,较单纯羊膜移植组(平均9周)角膜溃疡修复快,效果好结论羊膜为载体构建的组织工程角膜片可以有效治疗角膜溃疡。     

新鲜羊膜移植术治疗角膜溃疡的临床探讨

目的：探讨新鲜羊膜移植术治疗角膜溃疡的可行性、手术方法和临床效果。方法：采用新鲜羊膜移植治疗角膜溃疡16眼，其中细菌性角膜溃疡6眼，病毒性角膜溃疡3眼，复发性蚕蚀性角膜溃疡2眼，大泡性角膜病变2眼，持续性角膜上皮缺损3眼。手术方法有：单层羊膜移植6眼，多层羊膜移植7眼，羊膜移植联合带活性角膜缘的板层角膜移植3眼。术后随访6－19月。结果：术后均未见新鲜羊膜移植片急性排斥反应，16眼中14眼治愈。术后3－15天，炎症控制，疼痛消失。术后3－5周角膜溃疡愈合，12眼视力不同程度提高。1眼复发，1眼早期羊膜溶解。结论：新鲜羊膜移植是治疗角膜溃疡的有效方法。     

Establishment of a cultivated human conjunctival epithelium as an alternative tissue source for autologous corneal epithelial transplantation

PURPOSE: The corneal epithelium is essential for maintaining corneal transparency, and efforts have been made to develop improved techniques for corneal epithelial transplantation in patients with total limbal failure. We evaluated the suitability of transplanted cultivated human conjunctival epithelium (HCjE) as a corneal epithelium replacement in rabbits with total corneal and limbal deficiency. METHODS: HCjE cells, cultivated on human amniotic membrane (AM) to confluence and exposed to an air-liquid interface (air-lifted), were transplanted onto denuded rabbit corneas and monitored for 2 weeks. The cultivated HCjE sheet and the engrafted epithelium were analyzed by immunohistochemistry and transmission electron microscopy (TEM). RESULTS: The transplanted HCjE remained transparent, smooth, and without epithelial defects during the follow-up period. Both the cultivated HCjE cells and the engrafted epithelium manifested five to six layers of stratified squamous epithelium similar in morphology to normal corneal epithelium. The basal cells expressed the putative stem cell markers (ABCG2 and P63) and hemidesmosome and desmosome component proteins. The cytokeratins (CK4, CK13, CK3, and CK12) and MUC4 were found in the engrafted epithelium. However, MUC5AC was not expressed. The results indicate that HCjE cultivated on AM has the potential to be used as an alternative corneal epithelium. CONCLUSIONS: The transplantation of cultivated HCjE sheets is a promising technique for the treatment of eyes with limbal failure.     

外伤性角膜溃疡新鲜羊膜移植治疗研究

目的 探讨新鲜羊膜移植治疗外伤性角膜溃疡的效果。方法 外伤性角膜溃疡15例（15眼）经药物及物理等疗法综合治疗无效者，进行单纯羊膜移植手术，并观察治疗效果。结果 15例术后第1天角膜刺激症状开始减轻，术后第7天角膜刺激症状消失。5眼溃疡侵及角膜浅实质层者2周愈合。10眼溃疡侵及角膜深实质层者中9眼4周内愈合，1眼2周后行第2次羊膜移植6周内愈合。经临床观察无急性排斥反应，眼表修复良好，溃疡愈合，前房积脓消失，视力提高。经2－13月随访，无1例复发、无新生血管发生，眼表重建成功。结论 新鲜羊膜移植术可有效地控制角膜炎性反应，促进眼表重建。是有效的手术方法之一。     

Cyclic nucleotides in rabbit corneal endothelial cells: fresh tissue vs. tissue culture.

Quantities of adenosine 3′,5′-cyclic monophosphate were measured in rabbit corneal endothelial cells taken from fresh tissue and tissue culture. Higher levels of both nucleotides were observed when the cells were initially frozen in liquid nitrogen compared with those that were not. Adenosine 3′,5′-cyclic monophosphate was 14 times lower in the primary cultures compared to the fresh tissues while subcultures were about two-thirds that of the fresh tissue amount. Guanosine 3′,5′-cyclic monophosphate was four times higher in the primary cultures compared to the fresh tissue while subcultures were about two-thirds that of the fresh tissue amount. It is emphasized that the ratios of adenosine 3′,5′-cyclic monophosphate to guanosine 3′,5′-cyclic monophosphate were similarly high in both fresh tissue and subcultured cells approaching confluency, but quite low in primary outgrowths.     

Comments on corneal intrastromal tissue modeling with the femtosecond laser

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