眼科研究
眼科研究
안과연구
CHINESE OPHTHALMIC RESEARCH
2010年
2期
109-113
,共5页
廉井财%顾丽琼%石海云%王康孙
廉井財%顧麗瓊%石海雲%王康孫
렴정재%고려경%석해운%왕강손
LASIK%角膜%干眼%角膜神经纤维%超微结构
LASIK%角膜%榦眼%角膜神經纖維%超微結構
LASIK%각막%간안%각막신경섬유%초미결구
LASIK%cornea%dry eye%corneal nerve fiber%ultrastructure
目的 观察准分子激光原位角膜磨镶术(LASIK)手术前后角膜上皮超微结构的变化和角膜神经再生情况.方法 新西兰白兔48只,分为2组进行实验,每只兔1只眼行常规LASIK,分别在术后即刻、1d、1周,1、3、6个月,每组各取4只角膜,进行透射电镜、扫描电镜分析和角膜神经染色观察.结果 透射电镜观察显示:术后兔眼角膜表面的微绒毛不规则,微绒毛密度明显减少;扫描电镜可见细胞间连接异常,微绒毛有水肿和断裂的迹象.在术后1周左右基本恢复正常.角膜上皮微绒毛数量在术前和术后即刻相比差异有统计学意义(P＜0.05),与术后1d和7d相比差异无统计学意义(P＞0.05).角膜神经染色显示术后1d,神经损伤边界清楚,神经纤维被截断,至术后1个月即可见再生神经长入切断的角膜瓣内;术后6个月,再生神经长入角膜瓣内近中心区.结论 LASIK术后早期角膜上皮超微结构的改变,可能是造成术后干眼症的原因之一.LASIK术后被切断的角膜神经修复是从断端逐渐向角膜瓣内长入.
目的 觀察準分子激光原位角膜磨鑲術(LASIK)手術前後角膜上皮超微結構的變化和角膜神經再生情況.方法 新西蘭白兔48隻,分為2組進行實驗,每隻兔1隻眼行常規LASIK,分彆在術後即刻、1d、1週,1、3、6箇月,每組各取4隻角膜,進行透射電鏡、掃描電鏡分析和角膜神經染色觀察.結果 透射電鏡觀察顯示:術後兔眼角膜錶麵的微絨毛不規則,微絨毛密度明顯減少;掃描電鏡可見細胞間連接異常,微絨毛有水腫和斷裂的跡象.在術後1週左右基本恢複正常.角膜上皮微絨毛數量在術前和術後即刻相比差異有統計學意義(P＜0.05),與術後1d和7d相比差異無統計學意義(P＞0.05).角膜神經染色顯示術後1d,神經損傷邊界清楚,神經纖維被截斷,至術後1箇月即可見再生神經長入切斷的角膜瓣內;術後6箇月,再生神經長入角膜瓣內近中心區.結論 LASIK術後早期角膜上皮超微結構的改變,可能是造成術後榦眼癥的原因之一.LASIK術後被切斷的角膜神經脩複是從斷耑逐漸嚮角膜瓣內長入.
목적 관찰준분자격광원위각막마양술(LASIK)수술전후각막상피초미결구적변화화각막신경재생정황.방법 신서란백토48지,분위2조진행실험,매지토1지안행상규LASIK,분별재술후즉각、1d、1주,1、3、6개월,매조각취4지각막,진행투사전경、소묘전경분석화각막신경염색관찰.결과 투사전경관찰현시:술후토안각막표면적미융모불규칙,미융모밀도명현감소;소묘전경가견세포간련접이상,미융모유수종화단렬적적상.재술후1주좌우기본회복정상.각막상피미융모수량재술전화술후즉각상비차이유통계학의의(P＜0.05),여술후1d화7d상비차이무통계학의의(P＞0.05).각막신경염색현시술후1d,신경손상변계청초,신경섬유피절단,지술후1개월즉가견재생신경장입절단적각막판내;술후6개월,재생신경장입각막판내근중심구.결론 LASIK술후조기각막상피초미결구적개변,가능시조성술후간안증적원인지일.LASIK술후피절단적각막신경수복시종단단축점향각막판내장입.
Background The ultrastructure change and growth of corneal nerve after laser in situ keratomileusis (LASIK) are some influent factors to the stability of tear film and the sensibility of cornea.Some relevant studies are lack up to now.Objective This study is to observe the changes of ultrastructure of corneal epithelium and regeneration of corneal nerve fiber.Methods LASIK was performed on the lateral eyes of 48 New Zealand white rabbits.Rabbit eyes were excavated at instant in postoperation,one day,seven days,one,three and six months after LASIK.Change of corneal ultrastructure and corneal nerve staining were examined under the scanning electron microscope (SEM) and transmmision electron microscope (TEM) at the time points mentioned above.The numbers of microvilli of corneal epithelial cells in different postoperative time were analyzed.10% AuCl was used to evaluate the growth status of corneal nerve in different time after LASIK.Results Irregularity of microvillus of corneal epithelial cells,degrease of cell density were seen under the TEM and some cavities could been observed in the instant of postoperation.The connection abnormality of intercells,dropsy and rupture of microvillus were presented under the SEM,However,the ultrastructure of corneal epithelial cells was almost normal in 7 days after LASIK.The numbers of microvillus in corneal epithelial cells were significantly declined in the postoperative instant group compared with preoperative group (P＜0.05),but no evidently difference was found in postoperative 1 day and 7 days groups compared with preoperative group(P＞0.05).Corneal nerve staining showed that in 1 day after surgery,nerve plexus was deprivation and boundary of nerve injury was clear and nerve fibers were cut off.After one month some reborn nerve fiber grew into the cornea flap.Reborn corneal nerve fiber can be seen at center laser ablation area after six months of LASIK.Conclusion The ultrastructure change of corneal epithelial cells in the early stage after operation may be a important factor causing dry eye symptom following LASIK.The growth fashion of corneal nerve fibers is from the cutting edge to the center of corneal flap.
