兔角膜重度碱烧伤后异种猫前板层角膜移植重建角膜眼表  

Cat xenogeneic lamellar keratoplasty for reconstruction of corneal surface after severe corneal alkali burn in rabbits

作　　者：吴连胜[1,5] 陈建苏[1] 徐锦堂[1] 丁勇[2] 唐光霞[1] 郑佩娥[3] 雷自鸣 

机构地区：[1]暨南大学医学院眼科研究室,再生医学教育部重点实验室,广东省广州市510632 [2]暨南大学附属第一临床医学院眼科,广东省广州市510632 [3]暨南大学医学院病理教研室,广东省广州市510632 [4]侏罗纪生化有限公司,广东省恩平市529458 [5]浙江省温州市龙湾区第一人民医院眼科

出　　处：《眼科新进展》2010年第2期105-108,114,共5页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:30371519);广东省科技计划项目基金资助(编号:2006B35-801003、2007B031001005);暨南大学侨办重点学科基金资助(编号:51205004)~~

摘　　要：目的研究猫新鲜前板层角膜移植治疗兔右眼角膜重度碱烧伤的疗效。方法将16只5个月龄的健康雄性新西兰白兔右眼制作重度角膜碱烧伤模型,随机分成A、B两组,每组各8只兔,其中A组为猫(4只)→兔异种前板层角膜移植组,植片直径为11.0mm,植床直径为10.0mm;B组未行手术。A组兔术后及B组造模后用500g.L-1葡萄糖及复方氯霉素滴术眼直至处死,记录两组疗效指数,并分别于术后1个月、2个月、3个月取材进行术眼角膜病理学及扫描电镜检查。结果3个月内A组8只角膜碱烧伤兔经异种猫前板层角膜移植后,7只移植角膜保持透明,1只出现局限性角膜混浊和角膜新生血管;而B组未手术的8只兔中出现角膜白斑、新生血管4只,角膜溃疡、穿孔3只,角膜溶解穿孔1只,并且有4只发生睑球粘连等并发症。A、B两组治疗后1个月、2个月、3个月平均疗效指数差异均有统计学意义(均为P<0.05)。A组透明角膜中组织学及扫描电镜下的结构特征清晰;B组兔角膜中有明显的角膜水肿和炎性细胞浸润,组织学及扫描电镜下的结构特征显示细胞连接混乱、消失。B组扫描电镜还提示随着时间的延长,上皮细胞部分生长、增多,细胞连接差,角膜上皮排列紊乱;角膜内皮细胞数量明显减少或无,细胞连接混乱、消失。结论用异种猫新鲜前板层材料对重度兔碱烧伤角膜进行板层移植手术治疗在一定程度上可减轻伤后炎症反应,防止严重并发症的发生,维持眼表结构并可达到一定的光学治疗效果。Objective To investigate the efficacy of fresh cat xenogeneic lamellar keratoplasty for severe corneal alkali burn in right eyes of rabbits.Methods The severe corneal alkali burn models were made in right eyes of 16 New Zealand white male rabbits with 5 months old,and were randomly divided into two groups,8 rabbits in each group.Group A was treated with cat xenogeneic anterior lamellar keratoplasty（4 cats） onto rabbits;The diameter of graft was 11.0 mm,the diameter of implanting bed was 10.0 mm.Group B was without any treatment.About 500 g·L^-1 glucose and compound chloramphenicol were used to drop eyes of rabbits in Group A after operation and rabbits in Group B after modeling.Curative indices of two groups were recorded,corneal pathology and scanning electron microscope were taken at postoperative 1 month,2 months and 3 months,respectively.Results Within 3 months after cat xenogeneic anterior lamellar keratoplasty,7 rabbits were with transparent transplanted corneas,1 rabbit with localized corneal opacity and corneal neovascularization in 8 rabbits of Group A with corneal alkali burn;Eight rabbits were with keratoleukoma,4 rabbits with neovascularization,3 rabbits with corneal ulcer and perforation,1 rabbit with corneal melting and perforation and 4 rabbits with symblepharon in Group B.There were significant differences in average curative indices between the two groups at postoperative 1 month,2 months and 3 months,respectively（all P〈0.05）.Histology and electron microscopy revealed the structural characteristics of normal corneas were clear in Group A;But there were obvious corneal edema and inflammatory cell infiltration in Group B,histology and scanning electron microscope revealed the disarrangement or even disappearance of corneal structure.Scanning electron microscope indicated that the corneal epithelial cells were partly grown,increased and arranged disorderly,and the epithelial cell junction was poor;The corneal endothelial cells were significantly reduced or even disappeared,the endothelial

关 键 词：异种角膜移植 前板层角膜移植 角膜碱烧伤 兔 猫 

分 类 号：R772.2[医药卫生—眼科]