神经生长因子在角膜手术伤口愈合中的应用。

The use of nerve growth factor in surgical wound healing of the cornea.

作者信息

Cellini M, Bendo E, Bravetti G O, Campos E C

机构信息

Ophthalmology Service, Department of Surgery and Transplantation A. Valsalva, University of Bologna, Via Massarenti 9, IT-40138 Bologna, Italy.

出版信息

Ophthalmic Res. 2006;38(4):177-81. doi: 10.1159/000092626. Epub 2006 May 4.

DOI:10.1159/000092626

PMID:16679804

Abstract

BACKGROUND

Recent studies have shown how the topical application of nerve growth factor (NGF) has led to the repair of neurotrophic corneal ulcers with recovery of corneal surface sensitivity. The biological effect of NGF, at a corneal level, is mediated by the presence of specific receptors localized on the surfaces of the corneal and conjunctival cells.

OBJECTIVES

To evaluate the efficacy of NGF to promote corneal wound healing after cataract surgery.

METHODS

Thirty patients were divided into two groups (groups A and B) and underwent cataract surgery. After surgery patients in group A received 1 drop of NGF solution (10 microg of NGF dissolved in 50 microl of saline solution, 0.9% of sodium chloride) in the conjunctival fornix every 2 h (from 6 a.m. to 12 p.m.) for 2 weeks and then 4 times a day for another week. The patients in group B received 1 drop of hyaluronic acid 0.2% eye drops in the conjunctival fornix every 2 h for 2 weeks and then 4 times a day for another week. With optical coherence tomography (OCT) we evaluated the corneal thickness at the side of the surgical wound, the endothelial cell count and the incision line in the stroma 1, 7 and 21 days after surgery.

RESULTS

Before surgery in group A and in group B, the endothelial cell count was 2,607.4 +/- 261.0 versus 2,602.0 +/- 266.6 (p < 0.991), and the temporal cornea edge thickness was 639.2 +/- 24.7 versus 644.4 +/- 31.9 microm (p < 0.605), respectively. At 24 h after surgery, the results were: 2,523.2 +/- 280.5 versus 2,528.2 +/- 235.7 (p < 0.988) and 804.4 +/- 29.5 versus 802.6 +/- 35.0 microm (p < 0.953). After 7 days the cell count values were: 2,511.4 +/- 229.8 versus 2,490.0 +/- 230.4 (p < 0.361) and corneal thickness 713.6 +/- 16.5 versus 771.4 +/- 36.5 microm (p < 0.047). Finally, 21 days after surgery, the number of endothelial cells was 2,540.2 +/- 237.3 versus 2,503.4 +/- 224.5 (p < 0.382) and corneal thickness 645.2 +/- 22.6 versus 704.2 +/- 11.8 microm (p < 0.002). In the patients treated with NGF, on day 21, we found with OCT a complete wound healing, and the stromal incision was not visible.

CONCLUSIONS

This clinical experience shows that the topical administration of NGF is effective in accelerating the healing of surgical corneal wounds.

摘要

背景

最近的研究表明，局部应用神经生长因子（NGF）可促使神经营养性角膜溃疡修复，角膜表面敏感性恢复。在角膜水平，NGF的生物学效应是由角膜和结膜细胞表面存在的特异性受体介导的。

目的

评估NGF促进白内障手术后角膜伤口愈合的疗效。

方法

30例患者分为两组（A组和B组）并接受白内障手术。术后，A组患者每2小时（从上午6点至中午12点）在结膜穹窿滴入1滴NGF溶液（10微克NGF溶于50微升盐溶液，0.9%氯化钠），持续2周，然后每天4次，持续1周。B组患者每2小时在结膜穹窿滴入1滴0.2%透明质酸滴眼液，持续2周，然后每天4次，持续1周。通过光学相干断层扫描（OCT），我们在术后1、7和21天评估手术伤口一侧的角膜厚度、内皮细胞计数和基质中的切口线。

结果

术前，A组和B组的内皮细胞计数分别为2607.4±261.0和2602.0±266.6（p<0.991），颞侧角膜边缘厚度分别为639.2±24.7和644.4±31.9微米（p<0.605）。术后24小时，结果为：2523.2±280.5和2528.2±235.7（p<0.988），以及804.4±29.5和802.6±35.0微米（p<0.953）。7天后，细胞计数分别为：2511.4±229.8和2490.0±230.4（p<0.361），角膜厚度为713.6±16.5和771.4±36.5微米（p<0.047）。最后，术后21天，内皮细胞数量为2540.2±237.3和2503.4±224.5（p<0.382），角膜厚度为645.2±22.6和704.2±11.8微米（p<0.002）。在接受NGF治疗的患者中，在第21天，我们通过OCT发现伤口完全愈合，基质切口不可见。