全植床深板层角膜移植术后神经重建实验研究  

An Experimental Study of Corneal Nerve Regeneration after Full-Bed Deep Lamellar Keratoplasty

作　　者：彭艳坤[1] 姚玉峰[1] 朱也飞[1] 聂欣[1] 陈汉民[2] 

机构地区：[1]浙江大学医学院附属邵逸夫医院眼科,杭州310016 [2]浙江大学植物科学研究所,杭州310029

出　　处：《科技通报》2006年第2期186-190,共5页Bulletin of Science and Technology

摘　　要：目的观察新西兰兔全植床深板层角膜移植术后不同时期的角膜神经重建过程。方法新西兰兔麻醉后行冰冻保存角膜全植床深板层角膜移植术。术后分别于第7、21天,第1、2、3、4、6个月摘取术眼角膜,行乙酰胆碱酯酶神经染色,光学显微镜下观察。结果术后7天,植片内神经溃变,同时植床远端未损伤神经发出分支,穿过创缘进入植片。术后21天,神经溃变完成。术后1个月,植片内较多细、长、直的神经纤维,创缘外侧植床基质神经发出较多分支平行于创缘,但未进入植片。术后3个月,植床近端基质神经同一部位同时发出2￣4个分支进入植片,植片内细、长、直的神经纤维达到最多。术后4￣6个月,植片内神经重新塑型。少数植床近端基质神经形态基本接近正常。结论全植床深板层角膜移植术后神经再生恢复较慢。Objective To observe the morphological changes of New Zealand albino rabbits corneal nerve regeneration in the grafts after Full-Bed Deep Lamellar Kcratoplasty（FBDLK）. Methods By means of acetylcholinesterase staining histo- chemical techniques,the morphological features of cholinergie nerve regeneration were monitored under light microscope in those grafts at 7days,21days, lmonth,2months,3months,4months and 6months after FBDLK. Results At 7 days following surgery, nerves in the grafts showed the signs of degeneration, almost at the same time, the remarkable new axon terminals which sprouted from the undamaged stromal nerve bundles at some distance from the wound margin were detected .They were readily identified by their large caliber and heavily stained. This situation appeared unchanged until 21 days after surgery. At 21 days,the degeneration appeared to be compelete. At 1 month following surgery,the proliferation of straight ,long and fine neurites were evident in all preparations. At 3 months ,The second wave of regene-ration which was called genuine regeneration presented,and the extensive proliferation of dense,long neurites without branching were observed. At 6 months,h came to the stage of neural remodeling ,the severed nerves invading directly into the grafts ,but extended short distances. The morphology of regenerated nerves were almost normal. Conclusion These resuhs suggest that the corneal nerve reinnervation after FBDLK is relatively slow.

关 键 词：角膜移植 乙酰胆碱酯酶染色 神经重建 

分 类 号：R772.2[医药卫生—眼科]