应用异种脱细胞真皮的眼睑原位重建术的实验研究

目的探讨应用异种(猪)脱细胞真皮施行兔眼睑原位重建术后的组织相容性,比较异种(猪)脱细胞与异体巩膜替代睑板后的组织转归。方法采用兔眼睑缺损动物模型,随机分别给予异种(猪)脱细胞真皮、兔异体巩膜施行眼睑原位重建术。活体观察动物术后和移植物情况,于术后1、2、4、6、8和12周,取带植片的眼睑,光镜下观察替代材料和自体睑板交界处的组织病理学改变,包括炎症反应、纤维血管化情况和融合情况;取4、8和12周标本做透射电镜观察上述组织的超微结构改变。结果光镜和电镜下二者反应类似,差异无统计学意义。组织学检查显示异种脱细胞真皮引起的免疫和炎症反应轻微。结论异种(猪)脱细胞真皮在植入兔眼睑后有较好的组织相容性,并可引导新生胶原的生长,起到替代睑板的作用。

Experimental study of the eyelid reconstruction in situ with the acellular xenogeneic dermal matrix

Objective To investigate the histocompatibility of acelluar xenogeneic dermal matrix implanted in the rabbit eyelid reconstruction in situ and to compare the histological change of acellular xenogeneic dermal matrix and sclera replacing tarsus. Methods Thirty-six New Zealand rabbits were divided into two groups randomly. Establishment of the rabbits unilateral eyelid defect model, the eyelid reconstruction in situ were performed with either acellular xenogeneic dermal matrix or allogeneic sclera at random. The rabbits were clinically examined for inflammation and impant exposure and sacrificed 1, 2, 4, 6, 8 and 12 weeks after implantation. The eyelid with implant ( Xeno-ADM or allogeneic sclera ) were dislodged and the specimens were assessed histopathologically and ultrastructually with light microscopies respectively for evaluation of change of juncture between implant and autoallergic tarsal plates including inflammation, vascularization and confluence. The 4, 8 and 12 weeks specimens were assessed with transmission electron microscope micro structural changes of the above organizations. Results Light microscopy and electron microscopy showed no statistical difference between two groups. But histological examination showed that eyelid implanted with acellular xenogeneic dermal matrix had less immunological and inflammatory reaction than sclera-implanted group. Acellular xenogeneic dermal matrix could induce neovascular and collagenous fibers into implanted tissue. Conclusion Acellular xenogeneic dermal matrix is histocompatible to New Zealand rabbit, it can be used to support the eyelid as a substitution for tarsus.