利用后弹力层撕除术建立兔眼角膜内皮失代偿模型的评估  

Evaluation of rabbit corneal endothelial decompensation model established with Descemetorhexis technique

作　　者：叶向彧[1] 纪建丽 吴丽萍[1] 管雯斌[3] 盛耀华[1] 

机构地区：[1]上海交通大学医学院附属新华医院眼科,200092 [2]威海市立二院五官科,264200 [3]上海交通大学医学院附属新华医院病理科,200092

出　　处：《眼科研究》2009年第11期978-982,共5页Chinese Ophthalmic Research

摘　　要：目的利用后弹力层撕除术建立一种新的角膜内皮失代偿模型以便更好地了解该手术的组织反应。方法根据手术方法的不同将40只新西兰成年兔平均分为4组:角膜内皮刮除组、后弹力层撕除组、后弹力层撕除角膜内皮移植术(DSEK)组及DSEK供体组;右眼为手术眼。每组定期通过角膜内皮活体染色,眼前节照相和UBM至少观察2个月。结果后弹力层撕除组角膜始终保持混浊,角膜内皮刮除组和DSEK组角膜逐渐透明,角膜厚度逐渐降低。活体染色显示角膜后弹力层撕除组术后2个月仍无角膜内皮生长。结论后弹力层撕除术建立的角膜内皮失代偿模型显示了后弹力层撕除后角膜内皮愈合过程,可用于角膜内皮移植的研究。Objective Corneal endothelial decompensation is caused by many corneal diseases. It often results in severe clinical complications. Endothelial keratoplasty（EK） is a new therapy for corneal endothelial decompensation. This study aimed to investigate a new approach to establishing corneal endothelial decompensation animal model with Descemetorhexis technique in order to better understand the tissue response to EK. Methods Thirty New Zealand white rabbits were randomly divided into three groups according to different surgical procedures ： corneal endothelial cells （CEC） , Descemet ＇ s membrane and corneal endothelial cells （ DM ＋ CEC） as well as Descemet＇ s stripping with endothelial keratoplasty（DSEK） group and 10 eyes for each. The right eyes of rabbits were as surgery eyes. Other 10 rabbits were as DSEK donors. Corneal transparency, anterior chamber response and graft location were examined once per day for two weeks under the slit lamp. Corneal thickness was measured by ultrasound biomicroscope. Corneal endothelial cells were analyzed using vital staining with alizarin red and trypan blue in 2,4 and 8 weeks after operation. Results The cornea in DM ＋ CEC group remained opaque throughout the observation period. In CEC and DSEK group,corneal clarity was gradually restored and eorneal thickness was significantly less than that in the DM ＋ CEC group during the postoperative 8 weeks. There were significant differences in corneal thickness between the DM ＋ CEC group and CEC group or DSEK group during the postoperative 8 weeks（ P 〈 0.05 ）. The vital staining showed that most Descemetorhexis area was not covered by endothelial cells even 2 months after surgery. Conclusion A new corneal endothelial decompensation model is successfully established fur the study of corneal endothelial keratoplasly, which is helpful for understanding the woundhealing of rabbit corneal endothelium after Descemet＇ s membrane damage.

关 键 词：角膜 内皮细胞 失代偿 角膜内皮细胞移植术 

分 类 号：R772[医药卫生—眼科]