Kim J C, Tseng S C
Department of Ophthalmology, Chung-Ang University Hospital, Seoul, Korea.
Korean J Ophthalmol. 1995 Jun;9(1):32-46. doi: 10.3341/kjo.1995.9.1.32.
Human amniotic membrane isolated from the placenta contained basement membrane components such as type IV collagen, laminin, and 6 and 4 integrins, all of which remained detectable while preserved in glycerin for one week. One month after the n-heptanol removal of the total corneal epithelium and the limbal lamellar keratectomy, all rabbit eyes carried features of limbal deficiency, including conjunctival epithelial ingrowth, vascularization and chronic inflammation. Ten control eyes then received a total keratectomy, and 13 experimental eyes received an additional amniotic membrane transplantation. Three-month follow-ups revealed that all control corneas were revascularized to the center with granuloma and retained a conjunctival phenotype. In contrast, in the experimental groups, 5 corneas became clear with either minimal or no vascularization; the rest had either mild peripheral (5) or total (3) vascularization and more cloudy stroma. Using monoclonal antibodies for epithelial markers and matrix components, we concluded that the success correlated with the return of a cornea-like epithelial phenotype and the preservation of the amniotic membrane, whereas the failure maintained a conjunctival epithelial phenotype and the amniotic membrane was either partially degraded or covered by host fibrovascular stroma. Measures taken to facilitate the former might prove this procedure clinically useful for ocular surface reconstruction.
从胎盘中分离出的人羊膜含有基底膜成分,如IV型胶原、层粘连蛋白以及α6和α4整合素,当保存在甘油中一周时,所有这些成分仍可检测到。在正庚醇去除全角膜上皮和角膜缘板层角膜切除术后一个月,所有兔眼均出现角膜缘缺陷特征,包括结膜上皮内生、血管化和慢性炎症。然后,10只对照眼接受了全角膜切除术,13只实验眼接受了额外的羊膜移植。三个月的随访显示,所有对照角膜均向中央血管化并伴有肉芽肿,且保留结膜表型。相比之下,在实验组中,5只角膜变清,血管化轻微或无血管化;其余的角膜要么有轻度周边血管化(5只),要么有完全血管化(3只),且基质更浑浊。使用针对上皮标志物和基质成分的单克隆抗体,我们得出结论,手术成功与类似角膜的上皮表型的恢复和羊膜的保存相关,而手术失败则维持结膜上皮表型,且羊膜要么部分降解,要么被宿主纤维血管基质覆盖。采取措施促进前者可能证明该手术在眼表重建方面具有临床实用性。