Ishikawa T, Kanai A, Aquavella J V, del Cerro M
Juntendo Medical School of Medicine, Department of Ophthalmology, Tokyo, Japan.
Nippon Ganka Gakkai Zasshi. 1995 Feb;99(2):135-42.
To compare the recovery of corneal sensitivity and corneal regeneration following excimer laser and manual epithelial debridement, the corneal epithelium of the right eye of New Zealand white rabbits (n = 21) was manually debrided and the left eye was ablated with the excimer laser (47 microns depth, 5 Hz, and 160 mJ/cm2). We observed the wound healing rate and corneal sensitivity. The relative density of innervation on the intraepithelial layer was measured using gold chloride staining or right microscopic examination for 30 weeks. In the laser-ablated cornea sensitivity rapidly increased to a normal level by day 5, and then it continued to increase gradually and reached a maximum at day 42. Thereafter it remained elevated to 126 days and returned to normal at 210 days. There were significant differences in the recovery of sensitivity following excimer ablation and manual epithelial removal. The relative density of innervation on the intraepithelial layer after excimer ablation was significantly higher than manual debridement at day 35. We observed a correlation between increased sensitivity levels and increased nerve density. This result suggests that for photorefractive keratectomy or phototherapeutic keratectomy, manual debridement of the corneal epithelium should be performed before stromal excimer ablation.
为比较准分子激光和手动上皮清创术后角膜敏感性的恢复及角膜再生情况，对21只新西兰白兔右眼的角膜上皮进行手动清创，左眼用准分子激光消融（深度47微米，频率5赫兹，能量160毫焦/平方厘米）。观察伤口愈合率和角膜敏感性。采用氯化金染色或右显微镜检查测量上皮内层神经支配的相对密度，持续30周。在激光消融的角膜中，敏感性在第5天迅速增加至正常水平，然后继续逐渐增加，在第42天达到最大值。此后一直升高至126天，210天恢复正常。准分子激光消融和手动上皮去除后敏感性恢复存在显著差异。准分子激光消融后第35天上皮内层神经支配的相对密度显著高于手动清创。我们观察到敏感性水平增加与神经密度增加之间存在相关性。该结果表明，对于屈光性角膜切削术或光治疗性角膜切削术，应在基质准分子激光消融前进行角膜上皮的手动清创。
