准分子激光原位角膜磨镶术角膜瓣皱褶的实验研究  

Histopathological study of flap striae after LASIK in rabbits

作　　者：刘莉[1] 李一壮[1] 鲍连云[1] 周强[2] 

机构地区：[1]南京大学医学院附属鼓楼医院眼科南京宁益眼科中心,210008 [2]南京大学医学院附属鼓楼医院病理科

出　　处：《眼科研究》2008年第6期413-416,共4页Chinese Ophthalmic Research

摘　　要：目的通过组织病理学方法观察准分子激光原位角膜磨镶术(LASIK)后人为造成瓣皱褶与单纯LASIK术创伤愈合反应的不同。方法新西兰白兔右眼作为瓣皱褶实验组,左眼行LASIK术作为对照组。于术后1d、3d,1周、2周,1、3、6个月时处死取角膜,行苏木精-伊红、过碘酸希夫、Masson染色,行组织学观察。结果对照组无明显改变;皱褶组术后上皮基底膜呈波浪状,2周时上皮厚薄不等填平皱褶,2/3全角膜基质胶原纤维出现与皱褶一致的波浪走行。过碘酸希夫及Masson染色示各期瓣下层间深染。结论皱褶瓣上皮增生填平皱褶表面无益于患者视力的提高;皱褶瓣形态对基质的重塑产生影响,不利于临床处理皱褶及视力恢复;瓣皱褶愈合反应重且较为长久,有必要对长期皱褶进行研究。Objective Flap striae is one of the common complications of LASIK, Seldom histopathological researches about flap striae after LASIK are reported. The aim of this study was to evaluate and compare the wound healing process in the rabbits cornea after uneventful LASIK and LASIK with complication of flap striae. Methods LASIK with complication of flap striae and simple LASIK was performed in the right eyes and left eyes of 14 adult New Zealand white rabbits respectively. The rabbits were sacrificed and the eyeballs were enucleated 1 day,3,7,14 days, 1 month,3 and 6 months postoperatively for histopathological examination for the even LASIK and flap striae corneas. Results HE stain showed that the epithelial plug was restricted to the area around the corneal flap edge adhesion in the control group, and the arrangement of corneal stroma collagen fibers was regular. PAS stain and Masson stain showed no evident tinction. In the flap striae group,the hyperplasia of corneal epithelium was irregular in whole flap because of the undulation of epithelial basal membrane. The epithelium was thin in striae ridge and thick in striae trough, The stroma collagen fibers were disarranged even undulated accordance with basal membrane after 2 weeks, PAS stain and Masson stain showed obviously tinction in the area of adhesion between the corneal flap and stroma bed, Conclusion There is no evident histopathological change in wound healing process of uneventful LASIK group, The cornea epithelial proliferation and stroma histological arrangement in flap striae group are more obvious than LASIK group. Even after 6 months, the repair mechanism of striae flap still is active, but response of LASIK is stabled, The appearance of stroma fiber undulation which the same as flap striae wave means striae flap contribute to stroma remodeling at 2 weeks after surgery.

关 键 词：准分子激光原位角膜磨镶术 瓣皱褶 组织学观察 

分 类 号：R779.63[医药卫生—眼科]