Wang Ti, Zhu Lu, Peng Yinbo, Shen Nianci, Yu Yan, Yao Min, Zhu Jingyin
a Department of Ophthalmology , The 85th Hospital of PLA , Shanghai , China.
b Department of Ophthalmology , Huadong Hospital Affiliated to Fudan University , Shanghai , China.
Curr Eye Res. 2017 Nov;42(11):1413-1419. doi: 10.1080/02713683.2017.1344712. Epub 2017 Sep 14.
To compare the efficacy of photochemical-induced tissue cross-linking (PCL), utilizing Rose Bengal (RB) and 532 nm green light irradiation (RB-PCL), with standard sutures for closure of penetrating corneal incision in porcine cadaver eyes.
A full-thickness penetrating incision, 3 mm in length parallel to the limbus and perpendicular to the corneal surface, was made in the enucleated porcine cornea. Photochemical cross-linking was performed with tropical RB application and irradiation of 532 nm green light (0.6 W/cm) for 200, 250, and 300 seconds at laser fluences of 120, 150, and 180 J/cm, respectively, which was compared with the standard 10-0 nylon suture group. Following treatment, intraocular pressure to the point where wound leakage occurred (IOP) was measured. Corneal central thickness and surface temperature before and after PCL treatment were recorded. Optical coherence tomography (OCT) and scanning electron microscopy (SEM) were utilized to evaluate wound closure.
The mean corneal central thickness was increased from 812.0 ± 47.0 to 838.0 ± 45.6 µm after the incision as a result of cornea aqueous humor infiltration. RB penetrated approximately 140 μm into the porcine corneal stroma. The mean IOP for untreated blank group after incision was 4.27 ± 0.36 mmHg. Increased laser fluences produced increased IOP of 27.02 ± 3.01 (PCL), 31.60 ± 3.67 (PCL) and 36.73 ± 3.25 mmHg (PCL), which were statistically different from the control intact group. The mean IOP in the sutured cornea was 57.30 ± 4.59 mmHg. The average surface temperature difference before and after PCL treatment was 2.03 ± 0.45-2.47 ± 0.79°C. OCT demonstrated not only complete but also improved closure in comparison with disorganized collagen fibers after conventional suturing, which is further confirmed by SEM.
Complete and clinically relevant seal of full-thickness porcine corneal incision was achieved using PCL method ex vivo, which provides potential application of this technique in ocular wound closure.
比较使用孟加拉玫瑰红（RB）和532nm绿光照射（RB-PCL）的光化学诱导组织交联（PCL）与标准缝线在猪尸体眼穿透性角膜切口闭合中的疗效。
在摘除的猪角膜上制作一个全层穿透性切口，长3mm，平行于角膜缘且垂直于角膜表面。通过局部应用RB并分别以120、150和180J/cm²的激光能量密度照射532nm绿光（0.6W/cm）200、250和300秒进行光化学交联，并与标准的10-0尼龙缝线组进行比较。治疗后，测量出现伤口渗漏时的眼内压（IOP）。记录PCL治疗前后的角膜中央厚度和表面温度。利用光学相干断层扫描（OCT）和扫描电子显微镜（SEM）评估伤口闭合情况。
由于角膜房水浸润，切口后角膜中央平均厚度从812.0±47.0μm增加到838.0±45.6μm。RB渗入猪角膜基质约140μm。切口后未处理的空白组平均IOP为4.27±0.36mmHg。激光能量密度增加导致IOP升高，分别为27.02±3.01（PCL）、31.60±3.67（PCL）和36.73±3.25mmHg（PCL），与完整对照组有统计学差异。缝合角膜的平均IOP为57.30±4.59mmHg。PCL治疗前后的平均表面温度差为2.03±0.45 - 2.47±0.79°C。OCT显示与传统缝合后杂乱的胶原纤维相比，不仅实现了完全闭合，而且闭合效果更好，SEM进一步证实了这一点。
采用PCL方法在体外实现了猪全层角膜切口的完全且与临床相关的封闭，为该技术在眼部伤口闭合中的潜在应用提供了依据。
