全植床深板层角膜移植术后角膜上皮基底细胞的共焦显微镜活体动态观察  

Observation of the healing process of corneal epithelial basal cells after full bed deep lamellar keratoplasty with confocal microscopy

作　　者：叶宇峰[1] 姚玉峰[1] 周萍[1] 金玉奇[1] 潘飞[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院眼科,杭州310016

出　　处：《眼科研究》2006年第6期651-653,共3页Chinese Ophthalmic Research

摘　　要：目的通过对全植床深板层角膜移植术（FBDLK）后不同时期角膜上皮基底细胞的观察，了解角膜基底上皮在经冰冻保存过的角膜材料表面上的重建过程。方法20例（20眼）行FBDLK的患者在术后的不同时期分别进行裂隙式角膜共焦显微镜检查。对所得的清晰的角膜基底细胞的图像进行“反色”法电脑自动分析，获得基底细胞密度、细胞面积和细胞多形性变异率等数据并作统计学分析。结果FBDLK术后3～4d，植片表面上皮化已基本完成，此时植片中央区的基底层细胞密度较低，细胞体积较大呈近圆形；至术后15d时，角膜基底细胞的密度、面积和细胞多形性变异率等与正常对照组无明显差异；观察至术后12个月上述指标均保持稳定。结论-20℃冰冻保存角膜材料作为供体行FBDLK术后，植片表面能较快地完成上皮化，上皮基底细胞在术后15d时密度和形态已经恢复正常。Objective To investigate the healing process of corneal epithelial basal cells on the surface of cryopreserved tissue donor after full bed deep lamellar keratoplasty （ FBDLK）. Methods Twenty patients after FBDLK were examined with slit-scanning confocal microscope, and cryopreserved donor graft in - 20℃ was used in operation. The well-defined images of basal epithelial layer were selected, and the basal cell density, cellular area and polymegathism after operation were determined using the method of ＂invert image＂ conducted by the customized software and compared with normal value. Results The reepithelialization on the surface of donor were performed by corneal epithelial basal cells of recipients 3 - 4 days after the FBDLK. The density of re-epithelialized epithelial basal cells at the central corneas was 5 122 ± 515,5 348 ± 504,5 265 ±469,5 270 ± 440,5 309 ± 418 cells/mm^2 at0. 5,1,3,6,12 months after FBDLK respectively and was similar to normal value （ 5 335 ± 502 cells/mm^2）. Re-epithelialized epithelial basal cells were round and bigger in shape,and a big nucleus can be seen in the central part of these cells. The density and morphology of the corneal basal cells remained relatively stable up to 12 months after the operation. Conclusion Re-epithelialization of cornea epithelial basal cells of recipients on the surface of cryopreservaed tissue of donor can be achieved at a normal speed after full bed deep lamellar keratoplasty （ FBDLK）. Density and morphology of reepithelialized cells return to normal statue half-month after the operation.

关 键 词：深板层角膜移植 共焦显微镜 角膜上皮 基底细胞 

分 类 号：R779.65[医药卫生—眼科] R770.04[医药卫生—临床医学]