视网膜色素上皮移植方法的探讨

目的；探讨视网膜色素上皮移植的方法。 方法：以常规方法割备有色素兔眼视网膜色素上皮(RPE)细胞作为供体，移植到10只无色素兔眼．8只眼经外路法，即穿过巩膜和脉胳膜的方法；另10只眼内路法，即从睫状体平部进入玻璃体，制成人为的局限性视网膜脱离，将RPE细胞移植到受体眼视网膜下腔。术后第10、20、40、90天作光镜和电镜检查。 结果：内路法组，手术后40天光镜观察，移植区和非移植区神经视网膜层厚度无差别．透射电镜显示：移植的RPE细胞嵌入Bruch膜，光感受器外节在正常位置，术后90天，移植细胞内发现吞噬外节的次级溶酶体．外路法的8只眼因脉胳膜出血或视网膜穿破而失败。 结论：内路法是RPE细胞移植切实可行的方法。 （中华眼底病杂志，1997，13：160-162）

AN INVESTIGATION OF APPROACHES OF TRANSPLANTAITION OF RETINAL PIGMENT EPITHELIUM

PURPOSE:To investigate the approaches for transplanting retinal pigment epithelium. METHODS,Retinal pigment epithelial eells(RPR)of pigmented rabbits' eyes prepared by rotalne preparation of our institute,were transphmted in 18 unpigmemed rabbits'eyes.Eight eyes were undergone outer approach, i.e., transplanting the RPR cells to the subretinal space of recipient eyes by way of perforating sclera and choroid;while 10 eyes were undergone internal approach by way of the routine procedure of vitrectomy with making artificial localized retinal delachment. Light and transmisskm electrone microscopy examination were done at 10th, goth, 40th and 90th day after the operation. RESULTS: In internal approach group,tbe operated eyes,revealed no difference in thickness of the neural retinal layer in transplanted and non-transplantedarea 40 days after operation tinder light microscope. Transmission electrone microscopy revealed postoperatively the transplanted RPE cells attached to the Brucb's membrane and the outer segments of photoreeeplive ceils located at a normal position at the 40th dayland the secondary lysozymes with engulfed outer segment were found in the Iransplamed cells at the 90th day. Tbe outer approached operations in eight eyes were failed owing to ehoroid hemorrhage or perforation of retina.CONCLUSION:The internal appraach procedure is much effebtive and practical for transplantation of RPE cells. （Chin J Ocul Fundus Dis,1997,13:160-162）