Li Xia, Xiao Yun, Gao Xiao-Wei, Liu Yi, Lei Dai-Kun
Ophthalmology Center of the Army, General Hospital of Xinjiang Military Region, Urumchi 830013, Xinjiang Uygur Autonomous Region, China.
Int J Ophthalmol. 2020 Sep 18;13(9):1356-1360. doi: 10.18240/ijo.2020.09.03. eCollection 2020.
To investigate the mechanism and effect of trabecular tissue repair for corneal defect, and to provide a theoretical basis for its clinical application.
Trabeculectomy was performed on 40 (80 eyes) of 70 New Zealand white rabbits. Take trabecular tissue for backup. Thirty (30 eyes) corneal defect models were made, trabecular tissue was filled in the corneal defect, and the oblique cross stitch was used to suture the corneal laceration and debridement. Anterior segment image and optical coherence tomography (OCT) were performed at the time 1d, 1wk, 1 and 3mo after the model was made. After the observation, the cornea was taken and stained with trypanosome blue-alizarin red and the pathological tissue was examined.
Observation 1wk after surgery, the area of corneal defect was edema, but the corneal curvature was basically normal, and the anterior chamber existed under slit lamp. After 3mo of observation, most corneal defects were repaired in the form of corneal leucoma and corneal macula (73.3%), the filled trabecular tissue gradually became transparent, fused tightly with the corneal tissue, and the corneal curvature was relatively smooth. But in one case, the trabecular planter was partially detached, no serious complications such as corneal laceration occurred after the stitches were removed.
The trabecular tissue structure is similar to the corneal, and it can be used as a substitute for the corneal tissue defect by providing fiber scaffolds and cell amplification differentiation, and lay a foundation for the second-stage surgical treatment.
探讨小梁组织修复角膜缺损的机制及效果,为其临床应用提供理论依据。
对70只新西兰白兔中的40只(80眼)行小梁切除术,取小梁组织备用。制作30只(30眼)角膜缺损模型,将小梁组织填充于角膜缺损处,采用斜行间断缝合角膜创口及清创。于造模后1天、1周、1个月及3个月行眼前节图像及光学相干断层扫描(OCT)检查。观察结束后,取角膜行锥虫蓝-茜素红染色并检查病理组织。
术后1周观察,角膜缺损区水肿,但角膜曲率基本正常,裂隙灯下前房存在。观察3个月后,大部分角膜缺损以角膜白斑及角膜斑翳形式修复(73.3%),填充的小梁组织逐渐变透明,与角膜组织紧密融合,角膜曲率较光滑。但有1例小梁种植体部分脱离,拆线后未发生角膜裂伤等严重并发症。
小梁组织结构与角膜相似,可通过提供纤维支架及细胞增殖分化作为角膜组织缺损的替代物,为二期手术治疗奠定基础。