紫外光/核黄素-维生素E聚乙二醇琥珀酸酯交联方案对兔眼角膜基质超微结构和胶原纤维的影响  

Effects of ultraviolet light/riboflavin-vitamin E tocopheryl polyethylene glycol succinate cross-linking on ultrastructure of corneal stroma and collagen fibers in rabbits

作　　者：魏升升 李晶 张耀花 蔡艳 杜婧 高金荣 刘建国 李娟 李勇 WEI Shengsheng;LI Jing;ZHANG Yaohua;CAI Yan;DU Jing;GAO Jinrong;LIU Jianguo;LI Juan;LI Yong(The Eye Refractive Center,Shaanxi Eye Hospital,Xi’an People’s Hospital(Xi’an Fourth Hospital),Xi’an 710004,Shaanxi Province,China)

机构地区：[1]西安市人民医院(西安市第四医院),陕西省眼科医院眼屈光中心,陕西省西安市710004

出　　处：《眼科新进展》2023年第10期766-769,共4页Recent Advances in Ophthalmology

基　　金：陕西省科技计划项目(编号:2017JM8043);西安市卫健委一般研究项目(编号:2023yb14);西安市社会发展引导项目[编号:2017116SF/YX010(4)、SF1513(2)];陕西省社会发展攻关项目(编号:2016SF-274)。

摘　　要：目的探讨紫外光/核黄素-维生素E聚乙二醇琥珀酸酯交联方案(也称个性化快速角膜胶原交联手术,CF-CXL)对兔眼角膜基质超微结构和胶原纤维的影响。方法选取15只10~15周龄SPF级新西兰大白兔进行实验,所有动物右眼作为实验眼,均行CF-CXL,左眼作为对照眼。术后1周、1个月和3个月,注射过量戊巴比妥钠处死实验动物,取中央区角膜进行透射电镜检查。采用裂隙灯显微镜和眼前节OCT观察兔眼角膜的透明度、角膜厚度以及角膜胶原交联反应发生的深度。采用透射电镜对中央区角膜基质胶原纤维进行评估,以角膜胶原纤维横截面面积来评估胶原纤维的变化,使用ImageJ图像处理软件测量胶原纤维横截面面积。结果裂隙灯显微镜下观察可见,实验眼术后1周组、1个月组和3个月组角膜均保持透明,无角膜上皮损伤、角膜上皮下雾状混浊以及角膜瘢痕发生。与术前相比,实验眼术后1周组兔眼中央角膜厚度变薄,术后1个月组和3个月组变化不大。透射电镜检查结果显示,实验眼术后不同时间组均可见角膜基质中横行、纵行、斜行的胶原纤维板层分布,胶原纤维板层之间角膜基质细胞填充;角膜基质细胞内可见到散在分布的胶原原纤维;在胶原纤维的纵切面中,纤维周边可见错综分布的蛋白多糖装饰;胶原纤维的横切面可用于计算纤维的横截面面积。与对照眼相比,实验眼术后1周组、1个月组和3个月组胶原纤维横截面面积均明显增大,差异均有统计学意义(均为P<0.001),并且术后1个月组兔眼角膜胶原纤维横截面面积大于术后1周组和3个月组,差异均有统计学意义(均为P<0.001)。与对照眼相比,实验眼1个月组胶原纤维横截面面积增加21.37%。结论CF-CXL可以有效增加兔眼角膜基质胶原纤维的直径,对较薄的圆锥角膜是一种安全、有效的交联方式。Objective To investigate the effects of ultraviolet light/riboflavin-vitamin E tocopheryl polyethylene glycol succinate cross-linking(also known as custom fast corneal collagen cross-linking,CF-CXL)on the ultrastructure of corneal stroma and collagen fibers in rabbits.Methods Fifteen SPF New Zealand white rabbits aged 10 to 15 weeks were selected for the experiment.All rabbits underwent CF-CXL surgery on their right eyes,and left eyes were used as the control eyes.At 1 week,1 month and 3 months after surgery,the experimental rabbits were killed by injection of excessive pentobarbital sodium,and their central corneas were examined by transmission electron microscopy(TEM).The corneal transparency,corneal thickness and the depth of corneal collagen cross-linking were observed by the slit lamp microscopy and the anterior segment optical coherence tomography.The central corneal stromal collagen fibers were evaluated by TEM.The changes in collagen fibers were assessed by the cross-sectional area of corneal collagen fibers,which was measured by ImageJ.Results Under the slit lamp microscope,corneas in the experimental eyes remained transparent at 1 week,1 month and 3 months after surgery,without corneal epithelial injury,corneal subepithelial haze and corneal scar.Compared with pre-operation,the central corneas in the experimental eyes became thinner at 1 week after surgery,but this change was not significant at 1 month and 3 months after surgery.TEM results showed that transverse,longitudinal and oblique collagen fibrolamellar distribution was observed in the corneal stroma at different time points after surgery,and the corneal stromal cells were filled between the collagen fibrolamellar layers.Scattered collagen fibril was seen in corneal stromal cells.In the longitudinal section of collagen fibers,intricately distributed proteoglycan decoration was seen around the fibers.The cross section of the collagen fibers was used to calculate the cross-sectional area of the fibers.Compared with the control eyes,the cross-sectio

关 键 词：角膜胶原交联 胶原纤维 胶原纤维横截面面积 角膜胶原交联手术 

分 类 号：R772.2[医药卫生—眼科]