LASEK术后角膜上皮细胞的凋亡

目的探讨在准分子激光角膜上皮下磨镶术后,角膜上皮细胞凋亡的现象。方法采集行准分子激光角膜上皮下磨镶术后角膜上皮组织共100例,按制作上皮瓣时间5秒、10秒分两组各50例。用脱氧核苷酸末端转移酶缺口标记原位细胞检测法检测角膜上皮的凋亡细胞。并且观察术后的角膜上皮愈合、角膜上皮下雾样混浊分级和最佳矫正视力。结果在所有行准分子激光角膜上皮下磨镶术的患者角膜上皮均见有凋亡细胞,以基底细胞层多见。一组角膜上皮细胞的凋亡率为3.4%,二组的角膜上皮细胞的凋亡率为8%,两组比较P<0.05,差异有显著性。一组角膜上皮下雾样混浊haze术后10天和6月分别为20.99%、14.5%,而二组患者术后10天,6月上皮下雾样混浊为30%和20%。两组之间术后最佳矫正视力无差异。结论准分子角膜上皮下磨镶术后,角膜上皮细胞会发生凋亡现象,上皮细胞凋亡的轻重与上皮瓣制作的时间密切相关,且还与患者角膜上皮下雾样混浊产生有关。

Human corneal epithelial cell apoptosis after laser subepithelial keratomileusis

Objective To study the human corneal epithelial cell apoptosis after laser subepithelial keratomileusis. Methods There were 100 patients that dilute alcohol is used for epithelial removal during laser subepithelial keratomileusis , Exposure time were 20 seconds .In one group (50 patients ) the time were 5 seconds that maked epithelial flap. Two group (50 patients) making epithelial flap time was 10 seconds . The terminal deoxynucleotidy transferasa (TdT) mediated dUTP nick end labeling (TUNEL) assay were used to detect epithelial apoptosis cell. haze, visual acuity and corneal healing were observed at postoperation 1,3day, 1,3,6month. Results There were corneal epithelial apoptosis after LASEK, particularly in the based epithelial layer . The apoptosis percent was 3.4% in one group and 8% in two group (p<0.05) .The haze percents were 20. 9%,14.5% at postoperation 10 day ,6 month, compared with two group 30%,20% at postoperation 10 day and 6 month. Conclusions Based on our results we can conclude that cornea epithelial cell were apoptosis after LASEK. The cornea epithelial cells resulted in creasing apoptosis in time-dependent making epithelial flap.