Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Cornea. 2019 Dec;38(12):1582-1588. doi: 10.1097/ICO.0000000000002105.
To evaluate the corneal wound healing response after small incision lenticule extraction surgery.
Small incision lenticule extraction was performed in both eyes of 12 New Zealand White rabbits. The refractive spherical correction was set at -6.00 D. Two animals were analyzed at each time point (1 hour, 4 hours, 1 day, 3 days, 7 days, and 28 days). The corneas were evaluated using slit-lamp and in vivo confocal microscopy. After euthanatization, the corneal tissues were subjected to light microscopy, transferase 2'-Deoxyuridine 5'-Triphosphate (dUTP) nick end labeling assay, and immunofluorescence microscopy (CD11b, fibronectin, tenascin, alpha-smooth muscle actin [α-SMA]).
The corneas did not show any opacity at any time point except at the side-cut incision. By contrast, there was obvious scar tissue at the side-cut incision. Scattered, hyperreflective spots were seen by confocal microscopy from 1 hour postoperatively. Transferase dUTP nick end labeling-positive keratocytes were abundant near the femtosecond laser incision area at 1 hour and reached a peak at 4 hours postoperatively and then decreased. Inflammatory cells migrated from the incision into the central cornea, and this process began 1 hour after surgery and peaked at 7 days. Extracellular matrix components were deposited at the beginning of day 1 postoperatively, and the distribution pattern differed between the central cornea and the incision site. α-SMA-positive myofibroblasts were only detected at the side-cut incision.
The scar tissue response in the peripheral cornea is related to the epithelium debridement. Inflammatory cells begin to be recruited by 1 hour after surgery. Therefore, it is necessary to implement antiinflammation interventions at a very early stage.
评估小切口微透镜提取术后角膜伤口愈合反应。
对 12 只新西兰白兔的双眼进行小切口微透镜提取。屈光球性矫正设定为-6.00D。每个时间点（1 小时、4 小时、1 天、3 天、7 天和 28 天）分析 2 只动物。使用裂隙灯和活体共聚焦显微镜评估角膜。处死动物后，对角膜组织进行光镜、转移酶 2'-脱氧尿苷 5'-三磷酸（dUTP）缺口末端标记检测和免疫荧光显微镜（CD11b、纤维连接蛋白、腱糖蛋白、α-平滑肌肌动蛋白[α-SMA]）检测。
除侧切口外，角膜在任何时间点均无混浊。相比之下，侧切口有明显的瘢痕组织。术后 1 小时共聚焦显微镜可见散在、高反射斑点。术后 1 小时，靠近飞秒激光切口区域的转铁蛋白 dUTP 缺口末端标记阳性的角膜细胞丰富，并在术后 4 小时达到高峰，然后减少。炎性细胞从切口迁移到中央角膜，这一过程在术后 1 小时开始，在第 7 天达到高峰。细胞外基质成分在术后第 1 天开始沉积，中央角膜和切口部位的分布模式不同。仅在侧切口处检测到 α-SMA 阳性肌成纤维细胞。
周边角膜的瘢痕组织反应与上皮清创有关。炎性细胞在术后 1 小时开始被募集。因此，有必要在非常早期实施抗炎干预。
