Essepian J P, Rajpal R K, Azar D T, New K, Antonacci R, Shields W, Stark W J
Center For Sight, Georgetown University Medical Center, Washington, D.C.
Scanning. 1994 Sep-Oct;16(5):300-4. doi: 10.1002/sca.4950160508.
Corneal wound healing following excimer laser keratectomy is the major cause of regression of treatment results. The amount of anterior stromal haze that develops may be influenced by topical medications. Over a period of 6 months, we followed 15 New Zealand white rabbit eyes that underwent excimer laser keratectomy with the VISX 193-nm ArF laser at a fluence of 150 mJ/cm2 for a depth of 130 microns. Eyes were randomized to treatment with prednisolone acetate, diclofenac sodium (Voltaren), a combination of both, and a control group. Drops were administered four times a day for 1 week, two times a day for 3 weeks, and the drops were then tapered. All eyes were reepithelialized by 5 to 7 days. The tandem scanning confocal microscope (TSCM) was used to evaluate the corneal wound in vivo weekly for a month and monthly for 6 months. During the early postoperative period, the TSCM revealed significant anterior stromal keratocyte activation with cell elongation and the spindle-shaped appearance of fibroblasts in all groups. Collagenous stromal scarring was evident initially, then slowly decreased in all treatment groups. This study shows that TSCM is clinically useful for successive in vivo examinations of corneal wounds after excimer laser keratectomy and for comparing the effects of various topical medications.
准分子激光角膜切削术后角膜伤口愈合是治疗效果消退的主要原因。所形成的前基质 haze 的量可能受局部用药的影响。在 6 个月的时间里，我们跟踪了 15 只新西兰白兔眼，这些眼睛接受了 VISX 193 纳米 ArF 激光的准分子激光角膜切削术，能量密度为 150 mJ/cm²，切削深度为 130 微米。将眼睛随机分为用醋酸泼尼松龙、双氯芬酸钠（扶他林）、两者联合治疗的组以及一个对照组。滴眼液每天给药 4 次，持续 1 周，然后每天给药 2 次，持续 3 周，之后逐渐减少滴眼液用量。所有眼睛在 5 至 7 天内重新上皮化。使用串联扫描共聚焦显微镜（TSCM）在术后 1 个月内每周对角膜伤口进行一次体内评估，在 6 个月内每月进行一次评估。在术后早期，TSCM 显示所有组的前基质角膜细胞均有明显激活，细胞伸长，成纤维细胞呈纺锤形。胶原基质瘢痕最初明显，然后在所有治疗组中逐渐减少。本研究表明，TSCM 在临床上可用于准分子激光角膜切削术后角膜伤口的连续体内检查以及比较各种局部用药的效果。
