Drew A F, Schiman H L, Kombrinck K W, Bugge T H, Degen J L, Kaufman A H
Children's Hospital Research Foundation, Cincinnati, Ohio, USA.
Invest Ophthalmol Vis Sci. 2000 Jan;41(1):67-72.
Excimer laser photorefractive keratectomy creates a nonvascular wound of the cornea. Fibrin deposition and resolution after excimer laser photokeratectomy were investigated in relation to corneal repair and restoration of clarity in mice with a genetic deficiency of plasminogen.
A Summit Apex Laser (Summit, Waltham, MA) was used to perform 2-mm, 175-pulse, transepithelial photoablations that resulted in deep stromal keratectomies. Photokeratectomy was performed on the corneas of plasminogen-deficient (Plg-/-) mice and littermate control animals. Eyes were examined for re-epithelialization and clarity throughout the 21-day observational period. Histologic sections were taken during the observational period and fibrin(ogen) was detected immunohistochemically.
Re-epithelialization was rapid and complete within 3 days in both control and Plg-/- animals. Exuberant corneal fibrin(ogen) deposition was noted in Plg-/- mice and sparse fibrin(ogen) deposition in control mice on days 1 and 3 after injury. Fibrin(ogen) deposits resolved in control mice but persisted in Plg-/- mice (74% of eyes at 21 days; P < 0.004). Corneal opacification, scarring, and the presence of anterior chamber fibrin(ogen) occurred in plasminogen-deficient mice but not in control mice.
Fibrin(ogen) deposition occurs during corneal wound repair after photokeratectomy. Impaired fibrinolysis in Plg-/- mice caused persistent stromal fibrin deposits that correlated with the development of corneal opacity.
准分子激光屈光性角膜切削术会造成角膜的无血管伤口。研究了准分子激光角膜切削术后纤维蛋白的沉积和溶解情况,以及它们与纤溶酶原基因缺陷小鼠角膜修复和透明度恢复的关系。
使用Summit Apex激光(Summit公司,马萨诸塞州沃尔瑟姆)进行2毫米、175脉冲的经上皮光消融,造成深层基质角膜切除术。在纤溶酶原缺陷(Plg-/-)小鼠和同窝对照动物的角膜上进行角膜切削术。在整个21天的观察期内检查眼睛的上皮再形成和透明度。在观察期内取组织学切片,并用免疫组织化学法检测纤维蛋白(原)。
对照动物和Plg-/-动物在3天内上皮再形成迅速且完全。在损伤后第1天和第3天,Plg-/-小鼠角膜有大量纤维蛋白(原)沉积,对照小鼠纤维蛋白(原)沉积稀少。对照小鼠的纤维蛋白(原)沉积物溶解,但在Plg-/-小鼠中持续存在(21天时74%的眼睛有沉积;P<0.004)。纤溶酶原缺陷小鼠出现角膜混浊、瘢痕形成和前房纤维蛋白(原),而对照小鼠未出现。
角膜切削术后角膜伤口修复过程中会发生纤维蛋白(原)沉积。Plg-/-小鼠纤维蛋白溶解受损导致基质纤维蛋白沉积物持续存在,这与角膜混浊的发展相关。