纤维蛋白粘合剂粘贴双层基质透镜行兔板层角膜移植术

目的：研究纤维蛋白粘合剂(FS)粘贴的双层角膜基质透镜体内生物相容性，探讨使用该种材料行角膜移植的可行性。

方法：选取健康清洁级新西兰白兔15只，采用自身对照，以兔右眼为实验眼，左眼为对照眼。实验眼使用FS粘贴的双层角膜基质透镜作为移植材料行板层角膜移植手术，对照眼不进行人工干预。分别于术后7、14、28d使用手持裂隙灯观察双眼角膜情况，并进行生物相容性评分，同时取双眼角膜行HE染色进行组织病理学检测，观察角膜恢复情况。

结果：裂隙灯观察结果显示，至角膜移植术后28d，实验眼角膜上皮生长情况良好，角膜透明度基本恢复，水肿程度减轻，新生血管生长至角膜缘后未加重，未见上皮、内皮排斥线等排斥反应； 对照眼角膜透明，角膜上皮光滑。生物相容性评分结果显示，角膜移植术后实验眼角膜植片水肿程度逐渐减轻，透明度逐渐恢复，排斥反应较小，角膜植片的生物相容性较好； 至术后28d，实验眼和对照眼角膜透明度、水肿程度及新生血管生长程度均无差异(P>0.01)。组织病理学检测结果显示，至角膜移植术后28d，实验眼植片表面有4～5层角膜上皮细胞覆盖，角膜胶原排列整齐、规则，植片内未见明显炎性细胞浸润，双片透镜间分界消失，层间FS被机体完全吸收，植片与植床融合，未见明显分界。

结论：使用FS粘贴的双层角膜基质透镜作为植片行板层角膜移植术后恢复较好，排斥反应较小，生物相容性较好，可用于板层角膜移植。

Experimental study on rabbit lamellar corneal transplantation with double-layer corneal stromal lens attactched by fibrin sealant

AIM: To study the biocompatibility of double-layer corneal stromal lens attactched by fibrin sealant(FS)in vivo, and to explore the feasibility of using this material for corneal transplantation.

METHODS: Fifteen healthy and clean New Zealand white rabbits were selected for a self-control study. The right eye of the rabbit was used as the experimental eye and the left eye was used as the control eye. The experimental eyes used FS adhesived double-layer corneal stromal lens as the material for lamellar keratoplasty, and the control eyes did not undergo manual intervention. At 7,14, and 28d after surgery, a hand-held slit lamp was used to observe the cornea of the rabbits and then score the biocompatibility. The corneas of both eyes were taken for histopathological examination by HE staining to observe the corneal recovery at the same time.

RESULTS: Slit lamp observation results showed that by 28d after the operation, the corneal epithelium of the experimental eyes grew well, the degree of corneal transparency was basically restored, the degree of edema was reduced, the growth of neovascularization to the corneal edge was not aggravated, and no rejection reaction such as epithelial and endothelial rejection lines were seen; The control eyes had clear corneas and smooth corneal epithelium. The results of biocompatibility score showed that the degree of corneal implant edema gradually decreased, the transparency gradually recovered, the rejection reaction was less, and the biocompatibility of corneal implants was better in the experimental eyes after corneal transplantation. There were no differences in the degree of corneal transparency, edema and neovascularization growth between the experimental and control eyes at 28d after surgery(P>0.01). The results of histopathological examination showed that by 28d after corneal transplantation, there were 4-5 layers of corneal epithelial cells covering the surface of the implant in the experimental eyes, the corneal collagen was neatly and regularly arranged, no obvious inflammatory cell infiltration was seen in the implant, the boundary between the two lenses disappeared, the interlayer FS was completely absorbed by the organism, the implant was fused with the implant bed, and no obvious demarcation was seen.

CONCLUSION:Using FS pasted double-layer corneal stroma lens as a graft for lamellar keratoplasty has better recovery, less rejection and better biocompatibility, and can be used for lamellar keratoplasty.