紫外线A-核黄素交联后的角膜基质透镜泪道栓治疗兔干眼的实验研究  

Experimental study of the ultraviolet A-riboflavin cross-linking corneal stromal lenticule punctal plug for the treatment of dry eyes in rabbits

作　　者：杨帆[1,2] 田芳 裴澄 李娟[2] 李勇 邵毅 YANG Fan;TIAN Fang;PEI Cheng;LI Juan;LI Yong;SHAO Yi(The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710000,Shaanxi Province,China;Department of Ophthalmology,Xi’an People’s Hospital(Xi’an Fourth Hospital),Xi’an 710000,Shaanxi Province,China;Department of Ophthalmology,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200080,China)

机构地区：[1]西安交通大学附属第一医院,陕西省西安市710000 [2]西安市人民医院(西安市第四医院)眼科,陕西省眼科医院,陕西省西安市710000 [3]上海交通大学医学院附属上海市第一人民医院眼科,上海市200080

出　　处：《眼科新进展》2025年第4期286-290,共5页Recent Advances in Ophthalmology

基　　金：陕西省科学技术厅项目(编号:2024SF-YBXM-334);陕西省卫生健康高层次人才(团队)培育计划青年人才项目;西安市卫生健康委员会面上项目(编号:2023ms08)。

摘　　要：目的探讨紫外线A-核黄素交联后的角膜基质透镜泪道栓治疗兔干眼的疗效。方法选取新西兰大白兔32只(64眼),随机分为正常组、模型组、常规栓组和交联栓组,每组各8只(16眼)兔。正常组兔不予处理,模型组兔仅构建中重度干眼模型不予治疗,常规栓组和交联栓组兔建模后分别植入角膜基质透镜泪道常规栓和交联栓。分别在干预前及干预后1 d、1周、2周和4周对实验兔泪膜功能进行检查,包括泪液分泌量(SIT)、角膜荧光素钠染色及泪膜破裂时间(BUT)、泪河高度(TMH)测量。于干预后4周时收集各组兔角膜,HE染色观察角膜上皮变化。将未经交联和交联后的角膜基质透镜分别置于1 g·L^(-1)Ⅰ型胶原酶液中观察透镜直径随时间的变化。结果与干预前相比,交联栓组兔干预后2周和4周SIT、BUT和TMH均明显升高,常规栓组兔干预后4周SIT、BUT和TMH均明显升高,差异均有统计学意义(均为P<0.01)。干预后4周,交联栓组兔角膜染色情况好于常规栓组及模型组。HE染色结果显示,交联栓组兔角膜上皮厚度基本正常,上皮细胞排列基本整齐,基底层可见单层柱状上皮细胞层。交联后的角膜基质透镜溶解的时间比未交联的角膜基质透镜溶解时间显著增加。结论紫外线A-核黄素胶原交联后的角膜基质透镜泪道栓相较于角膜基质透镜泪道常规栓对兔干眼模型有更稳定的治疗作用,有望为临床干眼的治疗提供一种新的方法。Objective To investigate the efficacy of the ultraviolet A-riboflavin cross-linking corneal stromal lenticule punctal plug for the treatment of dry eyes in rabbits.Methods Thirty-two New Zealand white rabbits(64 eyes)were selected and randomly divided into a normal group,a model group,a conventional plug group and a cross-linking plug group,with 8 rabbits(16 eyes)in each group.Rabbits in the normal group were not treated.In the model group,moderate-to-severe dry eye rabbit models were constructed but no treatment was given.Rabbits in the conventional and cross-linking plug groups were implanted with conventional and cross-linking plugs after model construction,respectively.The tear film functions of the experimental rabbits,including tear secretion volume(SIT),corneal fluorescein sodium staining,tear film break-up time(BUT),and tear meniscus height(TMH),were detected before the intervention,1 day,1 week,2 weeks,and 4 weeks after the intervention.In addition,the corneas of each group were collected for hematoxylin and eosin(HE)staining to observe the changes of the corneal epithelium 4 weeks after the intervention.Finally,the non-cross-linking and cross-linking corneal stromal lenticules were placed separately in 1 g·L^(-1)of type I collagenase to observe the change of the lenticule diameter over time.Results In the cross-linking plug group,the SIT,BUT and TMH values 2 and 4 weeks after the intervention were significantly higher than those before the intervention(all P<0.01).In the conventional plug group,the SIT,BUT and TMH values 4 weeks after intervention were significantly higher than those before the intervention(all P<0.01).After 4 weeks of intervention,the corneal staining of rabbits in the cross-linking plug group was better than that in the conventional plug group and model group.The HE staining results showed that in the cross-linking plug group,the corneal epithelial thickness of rabbits was basically normal,epithelial cells were basically arranged in order,and a single layer of columnar epithelial cel

关 键 词：紫外线A-核黄素胶原交联 角膜基质透镜泪道栓 干眼 泪膜功能 

分 类 号：R777.3[医药卫生—眼科]