准分子激光切削脉络膜制作视网膜神经上皮-色素上皮联合移植片  

Microablation of choroidal tissue by excimer laser used for neuroretina-RPE cograft sheets

作　　者：陈少军[1] 阴正勤[1] 汪辉[1] 任茜[1] 罗启惠[1] 

机构地区：[1]第三军医大学西南医院眼科,重庆400038

出　　处：《医学研究生学报》2007年第3期243-245,I0001,共4页Journal of Medical Postgraduates

基　　金：国家自然科学基金资助项目(批准号:30270457)

摘　　要：目的：应用193 nm准分子激光切削脉络膜获得视网膜神经上皮-色素上皮联合移植片。方法：将胚胎21-24 d胎兔眼球冰浴下去除巩膜、前节和玻璃体,环钻制成视网膜神经上皮-色素上皮-脉络膜复合体。将复合体脉络膜面向上,平铺于7 mm圆形明胶片上,置于底衬白色的培养皿中。采用193 nm准分子激光治疗性切削术（PTK）模式发射,切削区域直径为6.5mm,能量范围80-130脉冲（pu lses）,以肉眼下切削区域可透见映衬其下的白色为宜。将切削后的标本浸泡于4%多聚甲醛中固定2-3 d,石蜡包埋、切片,苏木精-伊红（H-E）染色。结果：取材近后极部的标本见130脉冲切削脉络膜至视网膜色素上皮细胞（RPE）基底处,残留薄层脉络膜,并见正常复合体的移行带;而80脉冲切削则残留较多脉络膜组织;取材近周边部或赤道部标本,用50-80脉冲切削可去除脉络膜组织。结论：准分子激光切削脉络膜可获得较好的视网膜神经-上皮色素上皮联合移植片,避免了用酶消化对视网膜神经上皮的破坏。本实验胎兔眼取材近后极部激光切削以〈140脉冲为宜,取材近周边部或赤道部标本以50-80脉冲为宜。对不同的供者组织和取材部位,需摸索采用不同的切削点数而获得相同的切削深度。Objective ： To obtain neuroretina-RPE cograft sheets using a 193 nm excimer laser for microablation of choroidal tissue. Methods：The tye sclera of 3-week-old pigmented rabbit embryos were removed,the anterior segment, the vitreous,and several 5 -7 mm trephind specimens were obtained from neuroretina-RPE-choroid complex under icebath. To flatmount specimens on vibratomed 150 p.m sheets 50% gelatin with the choroidal side facing up , and ablate a 6.5 mm area by using excimer laser and ＂PTK＂mode（80- 130 pulses）. It was suitable that the area appeared as a whitish, partially transparent against a white background. Specimens were fixed in 4% paraformaldehyde for 2 -3 days,embedded in paraffin ,serially sectioned and staind with hematoxylin-eosin. Results：The specimens near the posterior pole were viewed a thin layer of choroidal tissue remains and the transition zone from normal neuroretina-RPE-choroid complex to ablated area after 130 pulses ablation, but 80 pulses ablation remained thick choroidal tissue;the specimens near the peripheral or equatorial may be removed choroidal tissue by 50 -80 pulses ablation. Conclusion：To use excimer laser may obtain better neuroretina-RPE cograft sheets and avoid enzymatical methods damage to neuroretina. The specimens near the posterior pole may use smaller than 140 pulses ablation,but the specimens near the peripheral and equatorial may use 50 - 80 pulses ablation. It is necessary for different donor tissues and parts of drawing materials to explore different ablation pulses for the same ablated depth.

关 键 词：准分子激光 脉络膜微切削 兔胚胎 视网膜神经上皮-色素上皮联合移植片 

分 类 号：R773.4[医药卫生—眼科]