自动板层角膜刀行板层角膜移植术实验研究

目的　观察使用自动板层角膜刀行板层角膜移植术后的光学效果。方法　用 34只大耳白兔随机分为 3组进行实验。 A、B两组建立板层角膜移植术模型 ,A组用自动板层角膜刀 ,B组用手工角膜刀 ,C组为正常对照组。结果　 A、B两组间角膜透明度有显著性差异 (P<0 .0 5 )。光镜和透射电镜下 ,术后 1～ 7d,吻合口处 A、B两组角膜细胞逐渐向成纤维细胞转化 ,胞体增大 ,富含粗面内质网、微管、微丝、高尔基体发达。术后 2 wk,吻合口处A组出现多数成纤维细胞 ,胞体增大 ,富含胞质、细丝 ,B组出现淋巴细胞浸润及新生血管生长 ,4wk时 ,胶原纤维排列 A组趋向规则 ,B组紊乱并有大量浸润细胞 ;6 wk时 ,胶原纤维排列 A组趋向正常 ,B组趋向规则。结论　自动板层角膜刀行板层角膜移植术后光学效果明显优越于手工角膜刀

Experimental research of automated corneal shaper in lamellar keratoplasty

Objective To observe the optical effect of automated corneal shaper in lamellar keratoplasty. Methods A total of 34 rabbits were randomized into 3 groups experimentally. Auto lamellar keratoplasty were performed in rabbits of group A and B,the former with automated corneal shaper and the latter with manual corneal shaper, and group C was used as control group.Results Statistically, there was significant or extreme difference between the transparency of group A and group B( P <0 05). Under the microscope and transmitrent electron microscope, from l to 7 days after operation, there was a gradual change in the keratocytes adjacent to wound margin characterized by the development of extensive rough endoplasmic reticulum, microtubules, microfilament and a prominent Glogi apparetus. At last these keratocytes developed into fibroblast like cells. 2 weeks postoperatively,the wound margin of group A was characterized by a great deal of fibroblast, enlarged size, extensive cytoplazm and microfilament, as for group B, the lymphocytes and vassularization were found. 4 weeks postoperatively, the collagenous fibers of the wound margin in group A tended to lie regularly, while in group B, the collagenous fibers lied irregularly and much cell infiltration was found . At the end of 6 weeks postoperatively, the collagenous fibers of the wound margin in group A tended to be normal arranged and in group B they tended to be regularly arranged.Conclusion The lamellar keratoplasty performed by automated corneal shaper is superior to that by manual corneal shaper because it can greatly improve the optical effect.