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1.
PURPOSE: To study the histopathologic evolution of the corneal limbus after alkaline burns according to the clinical severity and therapy used. METHODS: A prospective study of 15 eyes from 12 patients (9 men and 3 women) with moderate and severe alkaline burns was performed. All patients were divided into 2 groups in accordance with the clinical ocular severity and the therapy that was used: medical therapy, amniotic membrane transplantation (AMT), autologous limbal transplantation (ALT), and ALT combined with AMT (ALT + AMT). Biopsies were obtained from affected limbal areas immediately after the ocular burn and 9 months later. RESULTS: Limbal regeneration was limited to small areas in patients with moderate burns treated with medical therapy; in contrast, the limbal structure showed significant stromal and epithelial regeneration in patients with moderate burns treated with AMT. There was an important stromal regeneration with an incomplete reepithelialization in patients with severe burns treated with AMT. Patients treated with ALT showed a good reepithelialization with a defective stromal regeneration. Epithelial and stromal regeneration was notable in patients with severe burns treated with ALT + AMT. CONCLUSIONS: In patients with moderate alkaline burns, AMT improved both limbal stromal and epithelial regeneration more effectively than medical therapy. In patients with severe burns, the best reepithelialization and stromal regeneration were obtained with ALT + AMT. 相似文献
2.
板层角膜移植时间对角膜碱烧伤后血清特异性抗体的影响 总被引:7,自引:0,他引:7
目的 通过动物角膜碱烧伤模型,观察烧伤后不同时期和烧伤后不同时间行板层角膜移植手术的新西兰白兔血清特异性抗体水平与组织病理的变化。方法 新西兰白兔20只,制作单侧眼角膜中央部中度碱烧伤模型并完全随机分为5组:烧伤组、早期移植组两组(即3d移植组、7d移植组)、中晚期移植组两组(即2周移植组、5周移植组)。制备正常及碱烧伤角膜蛋白提取液,用酶联免疫吸附试验(ELISA)检测每组兔不同时期血清抗角膜变性蛋白抗体水平,并取不同时期的角膜做光镜、电镜观察。结果 角膜碱烧伤后机体产生特异性抗体,2周时升高明显,5~6周达高峰,之后下降,8周时再次烧伤对侧眼角膜,抗体生成明显。早期移植组抗体升高不显著,而中晚期移植组抗体变化趋势与烧伤组基本相似。光、电镜结果显示:移植组与烧伤组比较,上皮愈合好,基质纤维排列整齐,炎细胞浸润轻,新生血管少;早期移植组比晚期移植组恢复更好。结论 早期板层角膜移植治疗角膜碱烧伤可阻断机体针对碱烧伤后角膜变性蛋白的体液免疫反应过程。 相似文献
3.
目的:观察保存羊膜移植治疗兔角膜急性碱烧伤眼的组织学变化并探讨肿瘤坏死因子α(tumor necrosis factor α,TNF-α)和血小板源性生长因子(platelet derived growth factor,PDGF)的作用。方法:建立兔急性角膜碱烧伤模型,并于24h内行保存羊膜移植术(右眼,12眼/组),设左眼为对照组。术后观察双眼形态及角膜新生血管变化,并检测房水中TNF-α含量及角膜组织PDGF-BB的表达情况。结果:与对照组比较,治疗组炎症反应轻,角膜溃疡范围小,上皮再生速度快,新生血管长度短(P<0.05)。7,28d治疗组房水TNF-α含量分别为315.5±19.8ng/L和140.6±11.5ng/L,明显低于对照眼的363.0±28.5ng/L和283.5±19.9ng/L(P<0.05)。与对照组比较,治疗组PDGF蛋白表达升高(P<0.05)。结论:角膜急性碱烧伤后早期行保存羊膜移植术,能抑制眼内炎症,促进角膜修复,其作用与抑制TNF-α,促进PDGF表达有关。 相似文献
4.
M. Reim A. Conze H. J. Kaszuba 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》1982,218(1):42-45
After scraping away the corneal epithelium or after mild alkali burn, the regeneration of the cellular layers on the stromal surface was observed clinically. The average time of regeneration was 7 days after abrasion and 12 days after mild alkali burn. When the stromal surface was just covered by the newly regrown epithelium, the metabolite levels were determined. In the regenerated corneal epithelium after abrasion the ATP/ADP ratios were much higher than in the normal epithelium and much lower after the alcali burns.The GSH levels were diminished in both groups. The GSSG levels were elevated significantly only after the alkali burns resulting in a decreased redox ratio of the glutathione. The results seemed to be in accordance with morphological and enzymatical data of the regenerating corneal epithelium. Changes of the glutathione in the corneal endothelium were cautiously interpreted.Presented at the Annual General Meeting of the Association for Research in Vision and Ophthalmology. Sarasota, Florida 1979. 相似文献
5.
羊膜移植抑制兔角膜碱烧伤后新生血管增殖的研究 总被引:8,自引:0,他引:8
目的 比较采用保存羊膜和新鲜羊膜移植抑制角膜碱烧伤后新生血管增殖的效果 ;探讨应用保存人羊膜移植防治角膜碱烧伤后新生血管的手术时机。方法 制备角膜碱烧伤后新生血管增殖的动物模型 ;2 2只家兔 ( 2 2眼 )随机分为4组 :A组 ( 4眼 )作为对照组 ;B组 ( 6眼 )在碱烧伤的急性期行新鲜羊膜移植 ;C组 ( 6眼 )在急性期行保存人羊膜移植 ;D组 ( 6眼 )在瘢痕期行保存人羊膜移植。应用计算机彩色图像处理系统测定角膜新生血管面积。结果 3个移植组和对照组比较 ,角膜新生血管面积的差异均有显著性意义 (P <0 0 1) ;B组与C组比较无显著性差异 (P >0 0 5 ) ;C组的新生血管面积明显少于D组 (P <0 0 1)。结论 保存羊膜和新鲜羊膜移植均能有效地抑制角膜碱烧伤后新生血管的增殖 ,治疗效果无显著性差异 ;在角膜碱烧伤的急性期施行羊膜移植防治新生血管增殖的效果要优于在瘢痕期手术。 相似文献
6.
The preliminary report presents the results of application of ozone preparation in form of ophthalmic drops in 89 patients (134 eyes). This preparation has been used in virus conjunctival and corneal diseases as well as in corneal degenerations after inflammatory conditions and chemical burns. One observed as acceleration of the regeneration processes in active inflammatory conditions of the anterior eye segment; instead the cases of leucoma and corneal opacities did not show any clinical effect. 相似文献
7.
目的:探讨角膜热烧伤后角膜溃烂溶解穿孔以及眼内炎症的免疫学机制。方法:在大鼠角膜上制作热烧伤模型,在烧伤后的不同阶段,制备角膜,虹膜、脉络膜巩膜复合体以及视网膜平片,采用标准的ABC免疫组化方法,观察眼局部T淋巴细胞亚群,巨噬细胞、树突细胞,MHC Ⅱ类抗原阳性细胞的动态变化。结果:烧伤后早期,角膜及虹膜即有T淋巴细胞浸润,以CD3阳性细胞为主,MHCⅡ类抗原阳性细胞也轻度增多;当角膜溶解穿孔阶段,T淋巴细胞浸润达到高峰,在T淋巴细胞亚群中,CD4明显多于CD8阳性细胞;同时,巨噬细胞、树突细胞、MHCⅡ类抗原阳性细胞也大量出现。细胞密集分布于角膜缘,在溃疡溶解处,可见MHCⅡ类抗原阳性细胞及少至中等量CD3阳性淋巴细胞。Ⅱ类抗原阳性细胞在形态学上也发生了些变化,由初期的园形变为多形性,且大小不一。当烧伤恢复期病变稳定时,各种阳性细胞逐渐减少。结论:免疫反应参与了严重角膜烧伤的发病过程,在角膜溶解穿孔的发生中起重要作用。眼科学报 1997;13:70~74。 相似文献
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10.
Proliferation and regeneration effects of constructed human beta-nerve growth factor gene on transfected cat corneal endothelial cells in vitro 总被引:1,自引:0,他引:1
OBJECTIVE: To explore the mechanisms of proliferation and regeneration effects of a human nerve growth factor (beta-NGF) expression vector (pcDNA4-beta-NGF) on the transfected cat corneal endothelial cells in vitro. To provide a new method for long term cultivation of human corneal endothelial cells in vitro and to establish theoretical basis of gene therapy for corneal endothelial defects. METHODS: It was a experimental study. The human pcDNA4-beta-NGF expression vector was constructed and transfected into cultured cat corneal endothelial cells by Effectene lipofectine transfection technique. The expression of the reporter gene pcDNA4-beta-LacZ expression was used to determine the transfection efficiency 48 hours after the transfection. RT-PCR and immunohistochemistry techniques were used to check the transient expression status at mRNA and protein levels in cat corneal endothelial cells. Mitotic index and methyl thiazolyl tetrazolium (MTT) value were measured and cell numbers at different stages of cell cycles were determined by flow cytometer 96 hours after transfection. An in vitro quantitative cat corneal endothelial cell traumatic model was established which was used for observing the effect of human beta-NGF expression product on the DNA synthesis of cat endothelial cells and healing process of traumatized endothelial cells. RESULTS: A human nerve growth factor (beta-NGF) expression vector (pcDNA4-beta-NGF)was successfully constructed and confirmed by sequence analysis. Single layered pure cat corneal endothelial cells were obtained by a modified sliced tissue culture technique and confirmed by morphological analysis, neurone specific enolase immunohistochemistry study and transmission electronic microscope. Effectene lipofectine mediated transfection efficiency of pcDNA4-beta-NGF into cat corneal endothelial cells in vitro was 11.3%. The human beta-NGF could be highly expressed in the transfected corneal endothelial cells at mRNA and protein levels. Mitotic index, MTT value and G1 stage cell numbers, as well as traumatically defected endothelial cells numbers during the healing process of human beta-NGF transfected corneal endothelial cells were statistically differed from the pre-transfected cells and control groups. CONCLUSIONS: Effectene lipofectine transfection technique could be effectively used for transfecting pcDNA4-beta-NGF into cat corneal endothelial cells in vitro with good efficacy and the gene could stably express to improve the proliferation and regeneration of the cat corneal endothelial cells. This method could be managed as an experimental basis to be applied in the experimental study for transfecting the human beta-NGF gene into human corneal endothelial cells. Therefore a new method for resolving the problem of impossible regeneration of corneal endothelial cells could become possible. 相似文献
11.
大鼠角膜碱、酸、热烧伤后房水中TGF-β2的变化研究 总被引:1,自引:0,他引:1
目的:通过检测角膜烧伤后前房水中TGF-β2含量的变化,探讨在眼部内环境下TGF-β2与角膜烧伤之间的关系,为角膜烧伤治疗提供依据。方法:制备Wistar大鼠角膜碱、酸、热中度烧伤动物模型,分别于伤后4,8h;1,3,5,7,14,28,49d处死。采集房水:用20g/LBSA包被的毛细管于角膜缘处刺入角膜,吸取房水至20g/LBSA包被的离心管中,-70℃保存。标准品和样品进行酸激活处理。使用ELISA方法检测角膜烧伤后前房水中TGF-β2的水平。结果:大鼠角膜碱烧伤后4hTGF-β2的水平呈现一过性升高,然后下降,3d时TGF-β2含量再次升高,7d时达高峰,持续至7wk时降至正常。大鼠角膜酸烧伤后4hTGF-β2的水平呈现一过性升高,然后下降,低于正常对照组,两者差异显著。7d时房水中TGF-β2升至正常,然后一直保持低平状态。49d时我们检测房水中TGF-β2水平仍低于正常。大鼠角膜热烧伤后4hTGF-β2的水平呈现一过性升高,1d时降至最低,3d时开始增长,直到7d时我们检测仍高于正常,然后缓慢下降。结论:角膜烧伤后前房水中TGF-β2的含量发生变化,致伤原因不同,其变化方式不同。角膜碱烧伤和热烧伤后于7d时出现TGF-β2高峰,说明此时角膜处于免疫功能抑制状态,这对于维持角膜前房的免疫赦免状态非常重要,证明此时机体发挥了自我保护功能,避免产生过度的病理反应。角膜酸烧伤后TGF-β2水平始终低平,其原因尚有待于进一步研究。 相似文献
12.
目的 探讨角膜新生血管对大鼠角膜损伤神经再生的影响。设计 实验研究。研究对象 SD大鼠。方法 采用随机数字表法将18只SD大鼠分为3组,每组6只。A组行缝线铲针角膜基质层间切开及缝线诱导新生血管术,术后0、3、7天给予结膜下注射贝伐单抗;B组行缝线铲针角膜基质层间切开及缝线诱导新生血管术;C组0、3、7天行结膜下注射贝伐单抗操作。分别在术后1天、1周、2周、4周,采用裂隙灯照相法观察记录角膜新生血管面积;角膜共聚焦显微镜记录神经长度。采用Cochet-Bonnet知觉仪测量缝线区的角膜知觉,采用Schirmer试验泪液线测量右眼的泪液分泌量。术后4周角膜全层铺片免疫荧光染色,记录上皮下神经密度。主要指标 角膜新生血管面积比、神经长度、上皮下神经密度、角膜知觉、泪液分泌量。结果 A、B组术后1、2周有角膜新生血管生长,术后4周消退闭锁,C组无角膜新生血管生长。A组术后1、2周新生血管面积比为(10.86±1.57)%和(1.87±0.69)%,分别小于B组的(25.42±2.65)%和(6.48±1.10)%(P均=0.000)。术后1天A、B组神经长度分别为(151.02±4.74)μm、(149.69±4.32)μm(P=0.306);术后1、2、4周,A组神经长度均长于B组,分别为(193.84±2.25)μm与(155.73±2.98)μm、(217.15±2.08)μm与(166.21±2.41)μm、(220.70±1.41)μm与(203.76±1.74)μm(P均=0.000)。术后A、B组神经长度均有减少并有恢复趋势,C组无明显变化。术后4周A组损伤区上皮下神经密度(22.60%±2.02%)明显高于B组(9.41%±2.01%)(P=0.000)。A、B组上皮下神经短小稀疏、密度低,C组形态正常。A、B组术后1、2、4周时角膜知觉及泪液分泌量均无统计学差异(P均>0.05)。A、B组均有下降并恢复趋势,C组无明显变化。结论 角膜新生血管可能抑制角膜损伤神经再生,抑制角膜新生血管有利于神经再生。(眼科, 2017, 26: 106-111) 相似文献
13.
Tatjana von Fischern Ulrich Lorenz Willy-Günther Burchard Martin Reim Norbert Franz Schrage 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》1998,236(7):553-558
· Background: Mineral balance is essential for maintaining corneal transparency. In preliminary investigations, we found alterations
of mineral concentrations in the human cornea after chemical burns. In this prospective study the mineral content of the rabbit
cornea was quantified after experimental alkali burns. · Methods: Thirty-two eyes of rabbits were burnt for 30 s with 1 M
NaOH. A short period of saline rinsing followed, but no further therapy was given. The eyes of 20 healthy rabbits served as
a control. We measured the water content by weighing the cornea before and after drying. The mineral content of the cornea
was determined in different stromal layers using energy-dispersive X-ray analysis in the scanning electron microscope. Groups
of eight rabbits were examined on days 0, 1, 4 and 8 after the experimental burns. · Results: After alkali burns the mineral
composition of the corneal stroma changed considerably. Sodium was present in high concentrations immediately after burning,
up to 708 mmol/kg dry weight, and returned to normal on day eight. Chlorine increased significantly throughout the whole period.
Sulphur concentrations stayed almost normal, showing only a minute loss of ground substance after alkali burn. A considerable
and increasing edema could be concluded from the water content. · Conclusions: Alkali burns resulted in a dramatic change
of the corneal mineral content. Therapeutic intervention with appropriate solutions is required to restore and maintain the
normal mineral composition of the denuded corneal stroma.
Received: 10. December 1996 Revised version received: 18 August 1997 Accepted: 15 October 1997 相似文献
14.
杨秀梅 《眼外伤职业眼病杂志》2013,(9):670-672
目的探讨羊膜移植治疗早期眼表化学烧伤的临床效果。方法18例(24只眼)早期眼表化学烧伤,采用羊膜移植治疗,术后随访3—12个月。观察视力、羊膜植片情况、角膜恢复情况及并发症。结果术后矫正视力≤0.04者1只眼,0.05~0.1者2只眼,0.12—0.25者5只眼,≥0.3者16只眼,脱盲率95.8%(23/24),脱残率66.7%(16/24)。24只眼中羊膜移植成活22只眼,成活率91.7%。24只眼中角膜最终恢复透明8只眼,角膜遗留薄翳者13只眼,角膜斑翳者2只眼,角膜白斑者1只眼。6只眼角膜新生血管长人。18只眼眼表情况稳定。并发症:4只眼发生假性胬肉,2只眼睑球粘连。结论羊膜移植可有效地用于早期化学烧伤的眼表重建,减轻炎性反应,减少新生血管的生成,抑制纤维组织增生,有较好的疗效。 相似文献
15.
兔角膜碱烧伤的共焦显微镜及病理观察 总被引:1,自引:1,他引:1
目的采用角膜共焦显微镜活体动态观察兔角膜碱烧伤的病理改变,组织化学方法观察角膜组织病理学变化。方法NaOH造成兔角膜碱烧伤模型,烧伤后4d、20d、36d行角膜共焦显微镜检查及组织病理学检查。结果碱烧伤后4d,角膜即有炎性细胞浸润,出现少许CD4+、CD8+细胞;碱烧伤后20d,角膜基质中炎性细胞浸润明显,CD4+、CD8+细胞增多,瘢痕及新生血管形成;碱烧伤后36d,炎性细胞浸润减少,CD4+、CD8+细胞消失,仍可见瘢痕及新生血管。结论角膜共焦显微镜活体观察碱烧伤后角膜的创伤修复,反映角膜的病理状态,有助于指导临床治疗。 相似文献
16.
Corneal burns and matrix metalloproteinases (MMP-2 and -9): the effects of human amniotic membrane transplantation 总被引:4,自引:0,他引:4
Rigal-Sastourné JC Tixier JM Renard JP Maurin JF Pouliquen Y Legeais JM 《Journal fran?ais d'ophtalmologie》2002,25(7):685-693
PURPOSE: Human amniotic membranes have recently been used in ophthalmology to restore deleted ocular surface after burns. Matrix metalloproteinases-2 and -9 have been implicated in the development of neovascularization. In this study, MMP-2 and MMP-9 expression was analyzed by in situ zymography on rabbit corneal chemical burns with and without human amniotic membrane graft. Method: Corneal neovascularization was induced in 10 Fauve de Bourgogne rabbits by means of a heptanol chemical burn on controlled deep keratotomy using a Chiron ALK-E corneal shaper. Half of rabbits received acute amniotic membrane transplantation 30mn after chemical burn; the remaining five rabbits received medical treatment. In situ zymography is a recent nondestructive technique which preserved the fine morphological details of the cornea and showed the active enzyme location in different corneal layers. The MMP-2 and -9 substrate was gelatin, which was detected by fluorescent microscopy. RESULTS: There was an overexpression of MMP-2 and -9 in corneal burns versus control corneas. Expression of MMP-2 and -9 was low in corneal burn without amniotic membrane graft. Following amniotic membrane transplantation, MMP-2 and -9 were strongly expressed and clinical neovascularization and inflammation decreased. Active enzymes were located in epithelium layers in the uncovered group. In the covered group, the active enzymes were located in the anterior and posterior stromal layers. CONCLUSION: The results support a role for MMP-2 and MMP-9 in corneal burn neovascularization. Amniotic membrane transplantation can play a protective role by up-regulation of their biological expression. 相似文献
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人β神经生长因子基因转染体外培养猫角膜内皮细胞促进分裂再生的研究 总被引:1,自引:0,他引:1
目的 探讨人β神经生长因子真核表达载体(pcDNA4-13-NGF)转染体外培养猫角膜内皮细胞并促进细胞分裂再生的机制,为将该基因应用于促进人角膜内皮细胞再生的研究打下基础.方法 为实验研究.通过EffecteneTM脂质体介导将自行构建并经测序证实的人pcDNA4-B-NGF转染到体外培养的猫角膜内皮细胞中.采用分组对照的方法研究转染前后猫角膜内皮细胞分裂再生能力.转基因后48 h通过逆转录聚合酶链反应(RT-PCR)和免疫组织化学染色方法分别在mRNA和蛋白水平检测人β神经生长因子(β-NGF)的表达.转基因后96 h采用细胞四甲基偶氮唑盐染色(MTT)测量吸光度值、细胞有丝分裂指数、流式细胞仪检测G1期细胞比例及细胞损伤后愈合面积测量等方法检测目的 基因对猫角膜内皮细胞增殖活性的作用.结果 EffecteneTM脂质体可有效介导重组真核表达载体peDNA4-β-NGF转染到经改良方法体外培养的猫角膜内皮细胞中,转染效率为11.3%,并促进该细胞表达β-NGF.正常对照组β-NGF/β-actin比值结果为3.14,加脂质体组为3.23,pcDNA4质粒转染组为3.21,pcDNA4-β-NGF重组质粒转染组为4.53.培养液、正常对照组、加脂质体组、pcDNA4质粒转染组及pcDNA4-β-NGF重组质粒转染组平均A值分别为0.178±0.007、0.482±0.033、0.488±0.017、0.520±0.021及0.623±0.041.正常对照组、加脂质体组、pcDNA4质粒转染组及pcDNA4-β-NGF重组质粒转染组细胞有丝分裂指数分别为3.3%、3.0%、3.1%及7.7%.正常对照组、加脂质体组、pcDNA4质粒转染组及pcDNA4-β-NGF重组质粒转染组G1期细胞比例分别为68.1%、51.6%、60.4%及87.9%.结论 人β-NGF基因可通过EffecteneTM脂质体介导有效转染到体外培养的猫角膜内皮细胞中,并促进细胞分裂再生,为进一步将此基因转入人角膜内皮细胞的研究提供实验经验. 相似文献
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PURPOSE: To compare corneal surface evolution after moderate alkaline burns by impression cytology in patients treated with medical therapy or with amniotic membrane transplantation (AMT). METHODS: A prospective study of 24 eyes from 18 patients (13 men and 5 women) with moderate alkaline burns was performed. All patients were divided according to the clinical ocular severity and the therapy used. Twelve eyes were treated surgically with AMT and the other 12 eyes received only medical therapy. Corneal cytology was obtained immediately after the burns, and 1, 2, 5, and 9 months later. We differentiated between samples obtained from affected areas and areas not affected by the burns. Cellular size, nuclear size, and nuclear-cytoplasmic (N:C) ratio were examined in corneal epithelial cells, as was the presence of goblet cells in corneal epithelium. RESULTS: Nuclear size, cellular size, and N:C ratio in non-burn-affected corneal areas had no significant alterations in comparison with normal eyes. In contrast, in burn-affected corneal areas, these parameters were significantly worse, and the presence of goblet cells in corneal epithelium was frequent 1 month after severe burns. Cellular size, nuclear size, N:C ratio, and corneal conjunctivalization improved during the study in all patients, but corneal reepithelialization occurred earlier in patients treated with AMT than in patients with only medical therapy. CONCLUSION: Morphologic and morphometric analysis of corneal cells by impression cytology after ocular burns permits the establishment of cellular reepithelialization patterns in relation with limbal deficiency level and with clinical ocular severity. AMT improves corneal reepithelialization earlier than medical therapy in moderate alkaline burns. 相似文献
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Chalanova RI 《Vestnik oftalmologii》2004,120(2):11-15
One hundred and two (128 eyes) patients with stage 4 ocular burns underwent examinations. One-stage therapeutic keratoplasty was used in 67 (67.7%) patients. Retransplantation was made in 35 (34.3%) of patients due to graft rejection. According to the study, the more severe the clinical course of burn lesions is (cases that necessitated transplantation in the present research), the more pronounced changes are observed in the body immune reactivity of victims. In particular, the below peculiarities were observed: a progressing reduction of the contents of lymphocytes' and of B-lymphocytes; and a diminishing phagocytic activity of neutrophils in the peripheral blood registered at the terminal treatment stage in the patients after retransplantation versus the 1st-group patients with a more favorable clinical course. The compensatory increase of T-lymphocytes, T-helpers and of IgA, IgG was found to be less pronounced in group 2. A notably more intense sensitization response of the body to corneal antigens was established in the patients after retransplantation, which was a basis for using this index as a prognostication test in respect to the graft rejection crisis. 相似文献