CAJ | 학술논문

背景近年来基质金属蛋白酶(MMPs)在准分子激光术后创伤修复过程中的作用越来越受到学者们的关注.目的探讨MMPs抑制剂GM6001对兔准分子激光角膜上皮下磨镶术(LASEK)术后角膜上皮下雾状混浊(haze)形成的影响.方法 27只新西兰白兔双眼行-10.00D激光切削的LASEK,手术后动物被随机分为GM6001组、氟米龙组和阴性对照组,术后分别用150μmol/L的GM6001滴眼液、质量分数0.1%氟米龙和氧氟沙星滴眼液点眼.每天在裂隙灯下对兔LASEK术后角膜上皮下haze进行观察和分级.分别于术后2、4、8周各组随机选取6只眼行角膜共焦显微镜检查,制备角膜组织切片行组织病理学检查,在透射电子显微镜下行角膜组织的超微结构检查.结果 LASEK术后2周和4周,阴性对照组haze分级较高的眼数多于GM6001组和氟米龙组,差异均有统计学意义(P＜0.05),GM6001组和氟米龙组haze分级水平均明显低于阴性对照组(P＜0.01),但GM6001组和氟米龙组相比,差异无统计学意义(P＞0.05);术后8周组3个组间haze分级的总体比较差异无统计学意义(P＞0.05).术后2、4、8周GM6001组术区前部基质内角膜成纤维细胞数均较对照组和氟米龙组减少,差异均有统计学意义(P＜0.05),各时间点对照组和氟米龙组差异无统计学意义(P＞0.05).LASEK术后GM6001组和氟米龙组兔角膜上皮细胞的形态改变、胶原纤维排列的紊乱情况均轻于阴性对照组.结论 GM6001通过抑制LASEK术后MMPs对角膜基质的降解,从而抑制角膜基质成纤维细胞的增生及胶原纤维的合成,减少haze的形成,其疗效与氟米龙相似.
배경 근년래기질금속단백매(MMPs)재준분자격광술후창상수복과정중적작용월래월수도학자문적관주.목적 탐토MMPs억제제GM6001대토준분자격광각막상피하마양술(LASEK)술후각막상피하무상혼탁(haze)형성적영향.방법 27지신서란백토쌍안행-10.00D격광절삭적LASEK,수술후동물피수궤분위GM6001조、불미룡조화음성대조조,술후분별용150μmol/L적GM6001적안액、질량분수0.1%불미룡화양불사성적안액점안.매천재렬극등하대토LASEK술후각막상피하haze진행관찰화분급.분별우술후2、4、8주각조수궤선취6지안행각막공초현미경검사,제비각막조직절편행조직병이학검사,재투사전자현미경하행각막조직적초미결구검사.결과 LASEK술후2주화4주,음성대조조haze분급교고적안수다우GM6001조화불미룡조,차이균유통계학의의(P＜0.05),GM6001조화불미룡조haze분급수평균명현저우음성대조조(P＜0.01),단GM6001조화불미룡조상비,차이무통계학의의(P＞0.05);술후8주조3개조간haze분급적총체비교차이무통계학의의(P＞0.05).술후2、4、8주GM6001조술구전부기질내각막성섬유세포수균교대조조화불미룡조감소,차이균유통계학의의(P＜0.05),각시간점대조조화불미룡조차이무통계학의의(P＞0.05).LASEK술후GM6001조화불미룡조토각막상피세포적형태개변、효원섬유배렬적문란정황균경우음성대조조.결론 GM6001통과억제LASEK술후MMPs대각막기질적강해,종이억제각막기질성섬유세포적증생급효원섬유적합성,감소haze적형성,기료효여불미룡상사.
Background More and more attentions are paid to the effect of matrix metalloproteinases (MMPs) in the process of wound healing after excimer laser.Objective The present study was to investigate the effects of GM6001,a matrix metalloproteinases inhibitor,on haze formation after excimer laser epithelial keratomileusis (LASIK).Methods LASEK of -10.00 diopter was bilaterally performed on 27 New Zealand white rabbits and then divided randomly into the GM6001 group,Fluorometholone (FML) group and normal control group.Corneal haze was graded under dim light at 2 weeks,4 weeks and 8 weeks after operation,and the number of eyes in different grades of haze were compared among the three groups.Six corneal samples were harvested in each group for confocal microscope examination at 2,4,8 weeks.The corneal histopathological examination was carried out with the optical microscope,and the ultrastructure of the cornea was examined under the transmission electron microscope.Results The numbers of eyes of different corneal grades of haze at 2,4 or 8 weeks after surgery were significantly different among the three groups (P＜0.05).Compared with the normal control group,the corneal haze grades in the GM6001 group and FML group were apparently lower (P＜0.01),but there was no significant difference in the numbers of eyes of different corneal grades of haze between the GM6001 group and FML group (P＞0.01).The numbers of keratocytes in the GM6001 group were apparently lower than those in the normal control group and FML group in 2,4 or 8 weeks after operation (P＜0.05).No significant difference in the keratocytes was seen between the normal control group and FML group at various time points (P＞0.05).Corneal epithelial cell morphology,disordered arrangement of collagen fibers in GM6001 group and in FML group were less pronounced than in the negative control group.Conclusion GM6001 has an inhibitory effect on the formation of corneal haze after LASEK which suppresses proliferation and production of keratocytye with the similar efficacy as FML.