准分子激光兔角膜切削术后细胞凋亡和增殖

目的 寻找准分子激光角膜切削术（ＰＲＫ）术后细胞凋亡和激活增殖的动态联系,评价激光去除上皮（ＰＴＫ）和机械刮除上皮（ＭＥＳ）对凋亡和增殖的影响。方法 对１８只兔按ＰＴＫ和ＭＥＳ行ＰＲＫ（－９．９０Ｄ,６．０ｍｍ直径）,术后定期用活体共聚焦显微镜观察及制作病理切片,ＴｄＴ介导ｄＵＴＰ缺口末端标记（ＴＵＮＥＬ）原位显示凋亡细胞,激光扫描共聚焦显微镜观察凋亡细胞形态,定量统计比较凋亡水平差别。结果 ＰＲ

The apoptosis and proliferation after photorefractive keratectomy

Objective To search the correlation between the apoptosis and proliferation of keratocytes and investigate the influence of phototherapeutic keratectomy (PTK) and mechanical epithelial scrape (MES) on keratocyte apoptosis and proliferation.Methods Rabbit corneas received photorefractive keratectomy (PRK, -9.9 diopters, 6mm diameter). Animals were evaluated subsequently up to 6 months after surgery by in vivo confocal microscopy. Corneas were prepared for H.E. staining, corneal cell apoptosis was evaluated by terminal deoxyribonucleotidyl transferase mediated dUTP nick end labeling (TUNEL) to detect DNA fragmentation. Results Loss of keratocytes and keratocyte death were found anteriorly in the remaining stroma at 4h after PRK. Activated keratocytes observed by confocal microscopy repopulated within 1 month. A significant elevation of apoptosis was detected in keratocytes and epithelium at 4h, 3d, 1m after PRK. The level of keratocyte apoptosis was parallel to the loss of keratocytes at the early stage and was correlated with keratocyte proliferation in the later stage, PTK PRK was associated with lower levels of central corneal apoptosis and activated keratocytes than MES PRK. Conclusion It is suggested that the loss of keratocytes and keratocyte apoptosis be correlated with keratocyte activation and proliferation, which may result in haze and regression after PRK,and PTK PRK induce lower level of early keratocyte apoptosis and late keratocyte activation than MES PRK.