Epi-LASIK、PRK术后角膜上皮下雾状混浊的实验研究  

Comparison of rabbit corneal subepithelial Haze after Epi-LASIK or PRK

作　　者：刘维锋[1] 杜之渝[2] 赵武校[3] 黄正[2] 刘玺[2] 向一旻[2] 

机构地区：[1]南昌大学第三附属医院眼科,江西省南昌市330006 [2]重庆医科大学附属二院眼科中心,重庆市400010 [3]广西壮族自治区人民医院眼科,广西壮族自治区南宁市530021

出　　处：《眼科新进展》2009年第3期173-177,共5页Recent Advances in Ophthalmology

基　　金：重庆市卫生局医学科技计划基金资助(编号:2004-10)~~

摘　　要：目的通过对兔Epi-LASIK、PRK术后研究,探讨Epi-LASIK手术在角膜上皮下雾状混浊(Haze)减轻方面是否具有优越性及其机制。方法18只新西兰白兔,双眼分别建立Epi-LASIK和PRK模型,观察术后1周、4周、8周角膜Haze的变化、角膜组织形态学结构的变化、转化生长因子β2(transforming growth factor β2,TGF-β2)的表达。结果术后1周、4周Epi-LASIK组Haze(1.07±0.49、3.38±1.26)比PRK组(2.38±1.04、5.00±1.95)轻,差异均有统计学意义(Z1=-2.57、Z4=-2.41,P均<0.05),8周时差异无统计学意义(Z8=-0.96,P>0.05);组织形态学:Epi-LASIK组角膜上皮细胞的紧密性,角膜上皮基底膜的完整性、上皮与基质黏合程度,胶原排列规则性比同时间段PRK组都具有优越性;Epi-LASIK、PRK角膜上皮TGF-β2表达:1周、4周差异无统计学意义(P均>0.05),8周Epi-LASIK组表达比PRK弱,差异有统计学意义(t=-4.19,P<0.05);1周、8周Epi-LASIK、PRK角膜基质TGF-β2表达差异无统计学意义(P均>0.05),4周Epi-LASIK表达比PRK弱,差异有统计学意义(t=-2.53,P<0.05)。结论Epi-LASIK手术在减轻Haze方面较PRK具有优越性,其上皮瓣的保留对减少Haze的形成具有重要意义。Objective To evaluate whether epipolis laser in situ keratomileusis （Epi-LASIK） superior on decreasing Haze to photorefractive keratectomy （PRK）in rabbit eyes and explore its mechanism.Methods Epi-LASIK were performed in one eye of 18 New Zealand rabbits and PRK in the other eye.The changes of Haze,histological structure of cornea,expression of TGF-β2 in cornea were observed on the 1st week,4th week and 8th week postoperatively.Results Haze was statistically lighter following the Epi-LASIK（1.07±0.49,3.38±1.26）than PRK（2.38±1.04,5.00±1.95）on the 1st week and 4th week（Z1=-2.57,Z4=-2.41,P〈0.05）and no significant difference was found on the 8th week（Z8=-0.96,P〉0.05）.Corneal histological structures were better in Epi-LASIK than PRK at the same time period.Following Epi-LASIK,the compactedness of corneal epithelium,integrity of basement membrane of corneal epithelium,adhesion of epithelium and stroma and regulation of collagen arrangement in Epi-LASIK were much better than in PRK.For the expressions of TGF-β2,no significant differences were seen in corneal epithelium on the 1st week and 4th week,nor in corneal stroma on the 1st week and 8th week between Epi-LASIK and PRK（P〉0.05）,but there was a lighter expression of corneal epithelium after Epi-LASIK than PRK on the 8th week（t=-4.19,P〈0.05）and the same in corneal stroma on the 4th week（t=-2.53,P〈0.05）.Conclusion Epi-LASIK is superior on decreasing Haze to PRK,and its epithelial flap reservation is important to decrease Haze.

关 键 词：EPI-LASIK PRK 角膜上皮下雾状混浊 兔 转化生长因子Β2 

分 类 号：R779.62[医药卫生—眼科]