CAJ | 학술논문

目的:探讨聚羟乙基丙烯酸甲酯(PHEMA)海绵支架材料与角膜组织的生物相容性,评价改良聚羟乙基丙烯酸甲酯(PHEMA)-聚甲基丙烯酸甲酯(PMMA)一体化人工角膜植入兔与猴角膜的初步临床效果.方法:通过两个阶段化学聚合结合车床机械切削合成改良的一体化人工角膜.实验分为两个部分完成.第1部分(A组):将PHEMA海绵边裙材料植入10只正常兔角膜板层间,术后2,4wk及2,3,4mo分别行组织病理、免疫组织化学及电镜检查,观察海绵边裙与角膜组织的生物学愈合情况.第2部分(B组):8只兔眼和2只猴眼角膜囊袋内I期植入一体化人工角膜,术后临床观察材料与组织的愈合情况;术后3mo时行II期手术切除术眼角膜中央前板层角膜组织,暴露人工角膜中央镜柱,术后随访时间3～6mo,初步观察临床治疗效果. 结果:1)A组接受角膜板层间边裙植入术的10只兔眼,随访期间未见并发症:组织病理学显示,PHEMA海绵边裙材料植入术后2wk始有成纤维细胞长入,术后2～3mo时多量成纤维细胞长入并伴有新生血管生长;免疫组织化学显示,海绵孔隙中长入的细胞和角膜基质细胞均对波形蛋白免疫反应呈阳性;电镜下可见,成纤维细胞在海绵材料间隙中生长,细胞生长状态良好,并分泌胶原和细胞外基质.2)B组接受一体化人工角膜移植术的,6只兔眼一体化人工角膜均在位,另2只兔眼I期术后有前板层角膜基质融解.接受一体化人工角膜移植术的2只猴眼,I期和II期术后均未见明显并发症.结论:PHEMA海绵能与角膜组织良好的生物学愈合;改良PHEMA-PMMA一体化人工角膜植入术后能获得相对稳定的治疗效果.
목적:탐토취간을기병희산갑지(PHEMA)해면지가재료여각막조직적생물상용성,평개개량취간을기병희산갑지(PHEMA)-취갑기병희산갑지(PMMA)일체화인공각막식입토여후각막적초보림상효과.방법:통과량개계단화학취합결합차상궤계절삭합성개량적일체화인공각막.실험분위량개부분완성.제1부분(A조):장PHEMA해면변군재료식입10지정상토각막판층간,술후2,4wk급2,3,4mo분별행조직병리、면역조직화학급전경검사,관찰해면변군여각막조직적생물학유합정황.제2부분(B조):8지토안화2지후안각막낭대내I기식입일체화인공각막,술후림상관찰재료여조직적유합정황;술후3mo시행II기수술절제술안각막중앙전판층각막조직,폭로인공각막중앙경주,술후수방시간3～6mo,초보관찰림상치료효과. 결과:1)A조접수각막판층간변군식입술적10지토안,수방기간미견병발증:조직병이학현시,PHEMA해면변군재료식입술후2wk시유성섬유세포장입,술후2～3mo시다량성섬유세포장입병반유신생혈관생장;면역조직화학현시,해면공극중장입적세포화각막기질세포균대파형단백면역반응정양성;전경하가견,성섬유세포재해면재료간극중생장,세포생장상태량호,병분비효원화세포외기질.2)B조접수일체화인공각막이식술적,6지토안일체화인공각막균재위,령2지토안I기술후유전판층각막기질융해.접수일체화인공각막이식술적2지후안,I기화II기술후균미견명현병발증.결론:PHEMA해면능여각막조직량호적생물학유합;개량PHEMA-PMMA일체화인공각막식입술후능획득상대은정적치료효과.
AIM: To investigate the biocolonization of poly 2-hydroxyethy methacrylate (PHEMA) sponge with cornea tissue and evaluate the therapeutic effects of modified porous poly 2-hydroxyethy methacrylate-Polymethyl met-hacrylate (PHEMA-PMMA) Keratoprostheses (KPro) on rabbit and monkey corneas. METHODS:The KPro were made using two-stage polymerization combined with mechanical cutting. The experiment was divided into two groups. In the control group, ten normal rabbit eyes received lamellar implanta-tion of PHEMA sponges. The sponges were obtained 2 weeks, 1,2,3 and 4 months after operation. The cell proliferation and neovascularization inside the sponges were observed using light and transmission electron microscopy (TEM) and immunohistochemistry. In the experimental group, the porous PHEMA-PMMA KPros were inserted into the lamellar pockets of eight rabbit corneas and two monkey corneas (stage I operation). The healing process was investigated by slit-lamp microscopy. The anterior lamellar cornea tissues were removed 3 months after surgery, exposing the under-neath transparent core (stage II operation). The operated eyes were then followed up for 3-6 months.light microscope, fibroblasts started to grow into the cornea 2 weeks after operation; lots of cells, accompanied with new blood vessels, invaded into the cornea 2-3 months after surgery. Invading cells of sponge, as well as keratocytes, were positive for vimentin. Under the electron microscope, the invading cells looked healthy and were surrounded by extracellular matrix and collagen. In 8 rabbit eyes which received KPro implantation, anterior lamellar cornea melting happened in two eyes after the stage II operation. The remaining 6 corneas retained their central cores during observation after the stage II operation.Two monkey operated eyes were found no complication thoughout the whole follow-up.cornea. The modified PHEMA-PMMA KPros have obtained a relatively stable results after implantation into animal corneas.