Yin Yewei, Hu Tu, Xiang Aiqun, Fu Yanyan, Zhao Yang, Wu Xiaoying, Wu Xiaoying, Wen Dan
Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China.
Hunan Key Laboratory of Ophthalmology, College of Basic Medicine, Central South University, Changsha, Hunan 410008, P.R. China.
Exp Ther Med. 2021 Jul;22(1):681. doi: 10.3892/etm.2021.10113. Epub 2021 Apr 25.
The aim of the present study was to investigate the histological and morphological characteristics of corneal stromal lenticules extracted during femtosecond laser-assisted small incision lenticule extraction (SMILE) surgery by light and electron microscopy. A total of 20 human corneal stromal lenticules extracted during SMILE surgery were sent for microscopic examination immediately after surgery. Of these, six were observed under a light microscope and 14 were observed under an electron microscope. The smoothness of the front and rear surface of the lenticules observed under an electron microscope was rated on a scale of 0 to 4 according to unified evaluation criteria and the scores were statistically compared. Under the light microscope, the edge of the cross section of the corneal stromal lenticules was deeply stained and certain burrs and broken collagen fibers were observed. The swollen corneal stromal fibers were distributed irregularly, with a few bubbles of different sizes. Under the electron microscope, the surface of the lenticules ablated using a femtosecond laser was not perfectly smooth and the front surface was smoother than the rear surface. The side edge of the lenticules ablated using a femtosecond laser was not as regular as the edge cut using microscissors. Necrosis and dissolution of collagen fibers were observed near the surface of the lenticules. In conclusion, the surface quality of corneal stromal lenticules ablated using a femtosecond laser was not optimal when observed under a microscope. Increased attention should be paid to the histology and morphology of the corneal surface following laser ablation.
本研究的目的是通过光学显微镜和电子显微镜研究飞秒激光辅助小切口基质透镜切除术（SMILE）手术中提取的角膜基质透镜的组织学和形态学特征。共20个在SMILE手术中提取的人角膜基质透镜在手术后立即送去进行显微镜检查。其中，6个在光学显微镜下观察，14个在电子显微镜下观察。根据统一评估标准，对在电子显微镜下观察的透镜前后表面的光滑度进行0至4分的评分，并对分数进行统计学比较。在光学显微镜下，角膜基质透镜横截面的边缘染色较深，观察到一定的毛刺和断裂的胶原纤维。肿胀的角膜基质纤维分布不规则，有一些大小不同的气泡。在电子显微镜下，使用飞秒激光消融的透镜表面并非完全光滑，前表面比后表面更光滑。使用飞秒激光消融的透镜的侧边缘不如使用显微剪刀切割的边缘规则。在透镜表面附近观察到胶原纤维的坏死和溶解。总之，在显微镜下观察时，使用飞秒激光消融的角膜基质透镜的表面质量并非最佳。应更多关注激光消融后角膜表面的组织学和形态学。
