Addenbrooke's University Hospital Cambridge, 11 Perry Court, Clerk Maxwell Road, Cambridge CB3 0RS, UK.
Eye (Lond). 2009 Oct;23(10):1916-25. doi: 10.1038/eye.2008.383. Epub 2008 Dec 19.
Ocular hypotony and phthisis bulbi from persistent fistulae, ciliochoridal detachments, or inflammation, that cannot be treated currently. However, complete shutdown of the ciliary epithelium is rare. Secreting, transplanted ciliary tissue could restore the IOP to a level where further visual damage would not occur or even be reversed.
Allografts of ciliary epithelium and its substrate were placed on to the surface of the iris of normal albino rabbits. The progress of the transplanted tissue was followed in the untreated animals, those who had been immunosuppressed and those who had been immunosuppresed together with cold whole body perfusion for up to 55 days. Changes were assessed by slit-lamp observation, luconyl blue staining, fluoresceine angiography, and these were compared with the histology and electron microscopic appearances.
Transplants survived the period of ischaemia in the anterior chamber. They started to be revascularised within 4 days and were completely revascularised in 12 days. Untreated animals showed classical rejection phenomena. However, the ciliary epithelial tissue in those animals who were immunosuppressed and had been subjected to whole body perfusion remained normal and were secreting aqueous, as judged by the histological and electron microscopic appearances.
Perfused allografts of ciliary tissue will survive in the normal anterior chamber of the immunosuppressed rabbit, and the electron microscopic evidence indicates that the tissue is producing aqueous. If this can be shown to be adequate in the damaged eye, then ciliary transplantation could be a valuable tool in the management of severe intractable hypotony.
持续性瘘管、睫状脉络膜脱离或炎症导致的眼球低眼压和眼球萎缩目前无法治疗。然而，睫状上皮完全关闭的情况很少见。分泌的、移植的睫状组织可以将眼压恢复到不会发生进一步视觉损伤甚至逆转的水平。
将异体睫状上皮及其基质移植到正常白化兔虹膜表面。在未治疗的动物、免疫抑制的动物和免疫抑制并进行全身冷灌注的动物中，观察移植组织的进展，最长达 55 天。通过裂隙灯观察、鲁酮蓝染色、荧光血管造影评估变化，并与组织学和电子显微镜表现进行比较。
移植组织在眼前房缺血期间存活下来。它们在 4 天内开始重新血管化，在 12 天内完全重新血管化。未治疗的动物表现出典型的排斥现象。然而，在接受免疫抑制和全身灌注的动物中，睫状上皮组织保持正常并分泌房水，这可以通过组织学和电子显微镜观察来判断。
在免疫抑制兔的正常眼前房，经过灌注的异体睫状组织可以存活，电子显微镜证据表明该组织正在产生房水。如果这在受损眼中被证明是足够的，那么睫状移植可能是严重难治性低眼压管理的有价值工具。
