Singapore National Eye Centre, Singapore.
Invest Ophthalmol Vis Sci. 2012 Jul 26;53(8):4975-85. doi: 10.1167/iovs.12-10170.
To investigate the potential of refractive lenticule (RL) storage and re-implantation in vivo as a method for reversing RL extraction (ReLEx) and restoring corneal stromal volume.
ReLEx [-6.00 diopter (D) correction] was performed on six New Zealand White rabbits in one eye. Each extracted RL was tagged and orientated before storage at -80°C for 28 days. Each RL was then re-implanted autologously in the correct orientation after flap relifting. All animals were monitored for 28 days before being euthanized for immunohistochemical analysis. Unoperated fellow eyes were used as controls. All animals had regular pre- and postoperative slit lamp photography, in vivo confocal microscopy, anterior segment optical coherence tomography (AS-OCT), keratometry, and topography.
No intra-operative complications occurred and RL re-implantation was performed without complication. A mild intrastromal haziness was noted on day 3 after re-implantation (corneal haze grade: 2.20 ± 0.45), but corneas were clear on day 28 (0.20 ± 0.27). RL re-implantation restored central corneal thickness, and keratometric and topographic indices to near pre-operative values. Wound healing processes, marked by fibronectin and tenascin, and a few inflammatory cells were present along the re-implanted lenticular interfaces. No myofibroblasts formation, and Ki67- and TUNEL-positive cells were observed in the corneal stroma on postoperative day 28.
RL storage and re-implantation is a feasible technique for restoring stromal volume after myopic ReLEx, and may provide a method for restoring tissue in ectatic corneas, or provide an opportunity for further refractive surgery and presbyopic treatment.
研究准分子激光透镜（RL）储存和体内再植入作为逆转 RL 提取（ReLEx）并恢复角膜基质体积的方法的潜力。
在一只眼睛中对六只新西兰白兔进行 ReLEx [-6.00 屈光度（D）矫正]。每个提取的 RL 在储存于-80°C 28 天后都进行了标记和定向。在掀起瓣后，每个 RL 都以正确的方向进行自体再植入。所有动物在被处死进行免疫组织化学分析之前都监测了 28 天。未手术的对侧眼作为对照。所有动物均进行常规术前和术后裂隙灯照相、活体共聚焦显微镜、眼前节光学相干断层扫描（AS-OCT）、角膜曲率计和地形图检查。
无术中并发症，RL 再植入无并发症。再植入后第 3 天观察到轻度基质混浊（角膜混浊分级：2.20±0.45），但第 28 天角膜清晰（0.20±0.27）。RL 再植入可恢复中央角膜厚度以及角膜曲率计和地形图指数接近术前值。在再植入的透镜界面处，可见到纤维连接蛋白和腱蛋白标记的伤口愈合过程以及一些炎症细胞。在术后第 28 天，角膜基质中未观察到肌成纤维细胞形成和 Ki67-和 TUNEL 阳性细胞。
RL 储存和再植入是一种可行的技术，可用于恢复近视 ReLEx 后的基质体积，并且可以为扩张性角膜的组织恢复提供一种方法，或者为进一步的屈光手术和老视治疗提供机会。
