Esquenazi Salomon, He Jiucheng, Bazan Nicolas G, Bazan Haydee E P
Department of Ophthalmology and Neuroscience Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana 70112, USA.
J Cataract Refract Surg. 2005 Aug;31(8):1632-9. doi: 10.1016/j.jcrs.2005.01.011.
To evaluate in a rabbit model the differences in cellular and matrix stromal response in low and high attempted corrections between photorefractive keratectomy (PRK) and laser-assisted subepithelial keratectomy (LASEK).
Louisiana State University Health Sciences Center, Department of Ophthalmology and Neuroscience Center, New Orleans, Louisiana, USA.
Twenty-four eyes of 12 New Zealand albino rabbits were used. Photorefractive keratectomy was performed in 1 eye and LASEK was performed in the contralateral eye of all rabbits. In 5 animals, a low refractive correction (--3 diopters [D]) was attempted. In the other 5 rabbits, a high refractive correction (--7 D) was attempted. Two rabbits served as controls. The animals were followed for 7 days, after which they were humanely killed. The eyes were enucleated and processed for histopathology and immunohystochemical analysis.
All eyes showed an inflammatory response in the anterior stroma adjacent to the ablated area, with greater inflammatory cell infiltration with higher attempted corrections. Similar keratocyte apoptosis was found with low attempted corrections in PRK-treated and LASEK-treated eyes. However, there was a significant increase in keratocyte apoptosis in the PRK group at higher attempted corrections. Increased transformation to myofibroblasts and synthesis of chondroitin sulfate were observed adjacent to the ablated stroma in all eyes. With low corrections, no differences were observed between LASEK-treated and PRK-treated eyes. With higher attempted corrections, there was a significant increase in myofibroblast transformation and chondroitin sulfate synthesis in the PRK group. An irregular and discontinued collagen IV component of the epithelial basement membrane was observed in all PRK-treated and LASEK-treated eyes regardless of the attempted correction.
At higher attempted corrections, LASEK-treated eyes showed less keratocyte apoptosis, myofibroblast transformation, and up-regulation in the synthesis of chondroitin sulfate than PRK-treated eyes. These differences may account for better visual acuities and less stromal haze in higher attempted corrections in LASEK-treated eyes.
在兔模型中评估准分子激光角膜切削术（PRK）和准分子激光上皮下角膜磨镶术（LASEK）在低度数和高度数矫正尝试中细胞和基质的反应差异。
美国路易斯安那州新奥尔良市路易斯安那州立大学健康科学中心眼科与神经科学中心。
使用12只新西兰白兔的24只眼睛。所有兔子的一只眼睛行准分子激光角膜切削术，对侧眼睛行准分子激光上皮下角膜磨镶术。5只动物尝试低度数屈光矫正（-3屈光度[D]）。另外5只兔子尝试高度数屈光矫正（-7 D）。2只兔子作为对照。对动物随访7天，之后实施安乐死。摘除眼球并进行组织病理学和免疫组织化学分析。
所有眼睛在消融区域相邻的前基质层均显示炎症反应，随着矫正度数增加，炎症细胞浸润更明显。在PRK治疗和LASEK治疗的眼睛中，低度数矫正尝试时发现类似的角膜细胞凋亡情况。然而，在高度数矫正尝试时，PRK组角膜细胞凋亡显著增加。在所有眼睛的消融基质层相邻区域均观察到向肌成纤维细胞的转化增加以及硫酸软骨素合成增加。低度数矫正时，LASEK治疗和PRK治疗的眼睛之间未观察到差异。高度数矫正尝试时，PRK组肌成纤维细胞转化和硫酸软骨素合成显著增加。在所有接受PRK治疗和LASEK治疗的眼睛中，无论矫正度数如何，均观察到上皮基底膜的IV型胶原成分不规则且不连续。
在高度数矫正尝试时，与PRK治疗的眼睛相比，LASEK治疗的眼睛角膜细胞凋亡、肌成纤维细胞转化以及硫酸软骨素合成上调较少。这些差异可能解释了LASEK治疗的眼睛在高度数矫正尝试时视力更好且基质混浊较少的原因。
