深板层角膜内皮层移植治疗角膜内皮损伤的实验研究

目的:探讨深板层角膜内皮层移植在兔角膜内皮损伤模型的应用效果。方法:选择新西兰白兔24只,制作兔角膜内皮损伤模型第2d随机分为两组:实验组进行深板层角膜内皮层移植术组,对照组不予处理。分别于术后1,2,3,7,14d;1mo观察眼压、前房反应、并发症情况,术后1mo每组处死12只兔子,摘除眼球,12眼(两组各6眼)作病理切片检查,HE染色观察炎症细胞情况;另12眼(两组各6眼)用α-SMAWholemount染色法观察兔角膜内皮细胞瘢痕和肌成纤维细胞情况并进行细胞计数。结果:实验组角膜术后一直维持透明,对照组在术后5d明显变混浊,眼压、前房反应和并发症在两组间差异无显著性(P>0.05)。术后1mo两组实验兔在单位面积(500μm2)肌成纤维细胞数和炎症细胞数均有显著性差异(t=5.716,6.991;P<0.05)。结论:深板层角膜内皮层移植应用于兔角膜内皮损伤模型中炎症反应小,前房反应轻,能保持角膜透明,且并发症少。

Experiment study on the deep lamellar endothelial keratoplasty for corneal endothelial wound in rabbit model

AIM:To evaluate the deep lamellar endothelial keratoplasty(DLEK) for corneal endothelial wound in a rabbit model.METHODS:Totally 48 eyes(24 cases) with corneal endothelial wound model were studied,which were divided into 2 groups in postoperative 2nd day:the DLEK surgery was performed on experimental group(n=12) and the other cases(n=12) were as the control group.The postoperative examinations including the intraocular pressure(IOP),reaction of the anterior chamber and complications were performed on 1,2,3,7,14days;1 month after surgery respectively.A rabbit selected randomly in the two groups(n=6,respectively) was killed in 1 month after operation and extirpated the eyeball to observe the condition of myofibroblast and inflammatory cells and compare their difference.RESULTS:There were no significant difference of lOP and reaction of the anterior chamber among the two groups at 3d after operations(P>0.05);Comparing with control group,the complications didn’t increased.There was significant difference on myofibroblast(t=5.716,P<0.05)and inflammatory cells(t=6.991,P<0.05).CONCLUSION:DLEK have less complications,inflammatory reaction and reaction of the anterior chamber,also can maintain IOP and cornea transparence for corneal decompensation rabbit model.