Tanaka T
Department of Ophthalmology, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
Jpn J Ophthalmol. 2000 Nov-Dec;44(6):579-90. doi: 10.1016/s0021-5155(00)00269-0.
We investigated the keratocyte response and stromal remodeling after corneal incision and photorefractive keratectomy to understand the histophysiological and immunohistochemical differences between these two types of surgery.
Corneal incision or photorefractive keratectomy was performed in rabbits or rats. Then we chronologically observed the histological changes and the changes in the localization of extracellular matrix proteins.
In both types of surgery, the keratocyte population at the damaged stroma became sparse, and the cells began undergoing apoptosis immediately after the surgical procedure. Subsequently, activated keratocytes migrated into the acellular zone, and the cells formed multiple layers at the resurfaced subepithelial regions. We observed deposition of amorphous substances between keratocytes that had migrated, and stromal remodeling appeared to start. Three months after surgery, the corneal structure had recovered to a near-normal condition at the corneal incision. After photorefractive keratectomy, however, extracellular matrix proteins were strongly immunoreactive at the subepithelial regions.
These results suggest that the stromal wound-healing processes are similar after corneal incision and photorefractive keratectomy. A corneal incision may induce a transient keratocyte response during stromal remodeling, but photorefractive keratectomy may induce a sustained keratocyte response.
我们研究了角膜切开术和准分子激光原位角膜磨镶术后角膜细胞的反应和基质重塑，以了解这两种手术在组织生理学和免疫组织化学方面的差异。
对兔或大鼠进行角膜切开术或准分子激光原位角膜磨镶术。然后我们按时间顺序观察组织学变化以及细胞外基质蛋白定位的变化。
在这两种手术中，受损基质处的角膜细胞数量均变得稀疏，并且细胞在手术过程后立即开始发生凋亡。随后，活化的角膜细胞迁移至无细胞区，并且这些细胞在重新形成的上皮下区域形成多层。我们观察到迁移的角膜细胞之间有无定形物质沉积，并且基质重塑似乎开始。手术后三个月，角膜切开处的角膜结构已恢复至接近正常状态。然而，在准分子激光原位角膜磨镶术后，上皮下区域的细胞外基质蛋白具有强烈的免疫反应性。
这些结果表明，角膜切开术和准分子激光原位角膜磨镶术后基质愈合过程相似。角膜切开术可能在基质重塑过程中诱导短暂的角膜细胞反应，但准分子激光原位角膜磨镶术可能诱导持续的角膜细胞反应。
