羊膜移植联合鸡角膜缘上皮移植治疗兔全角膜表层损伤的组织学改变

目的：研究羊膜移植术和联合鸡角膜缘上皮移植（联合移植）术治疗兔全角膜表层损伤的组织学改变。方法：兔39只分为3组，每组13只。对照组，将角膜及角膜缘外3mm的表层组织去除；羊膜移植组，在去除表层组织的创面上移植羊膜；联合移植组，在羊膜移植片表面角膜缘区移植鸡角膜缘上皮。手术当天各组处死1只兔，7、28、90、105天各组处死3只兔，摘除眼球分别进行光镜、免疫组化，透射电镜及扫描电镜检查。结果：对照组：角膜紊乱，表面不平，上皮表面微绒毛稀少，基质纤维血管化。羊膜移植组及联合移植组：羊膜结构逐渐被基质胶元纤维取代和改建，基质纤维平行排列，角膜表面光滑，上皮表面微绒毛丰富，细胞之间可见桥粒连接。结论：羊膜移植术和联合鸡角膜缘移植术治疗兔角膜广泛损伤，能抑制新生血管和纤维组织向角膜生长，较快促进眼表重建。

The histopathologic changes of amniotic membrane transplantation with or without chicken corneal limbal graft for ocular surface reconstruction in rabbits with entire corneal superficial damage

Objective To observe the histopathologic changes of amniotic membrane transplantation (AMT) with or without chicken limbal graft for the treatment of the rabbit entire corneal and limbal superficial damage. Methods Prepare the preserved amniotic membrane.39 new Zealand white rabbits were divided into three groups:the control group,the superficial entire corneal tissue and limbal were removed;the group of AMT,the amniotic membrane graft was put on the surface of cornea and limbus after the superficial tissue removed;the group of AMT with chicken limbal graft.Examination of cornea with light microscope,electron microscope and immunohistochemistry in different period. Results The control group:the structure of corneal stroma was in disorder.More neovascules and goblet cells were seen.The epithelial cells were big and the microvilli were less and short.The amniotic membrane transplantation group and the amniotic membrane transplantation with chicken limbal graft group:the new corneal collagen fibril and corneal cells replaced gradually amniotic membrane,corneal stroma was remodlled with regular arrangement of the collagen fibril.In the area of epithelization,goblet cells were fewer,corneal surface appeared to be smooth.The microvilli in the area of healing were abundant.The junctions of desmosis between cells were seen. Conclusion The group of AMT or with chicken limbal graft inhibited the corneal neovascularization and promoted the reconstruction of ocular surface.