Latvala T, Barraquer-Coll C, Tervo K, Tervo T
Helsinki University Central Hospital, Eye Clinic, Finland.
J Refract Surg. 1996 Sep-Oct;12(6):677-83. doi: 10.3928/1081-597X-19960901-08.
Our aim was to describe wound healing and nerve regeneration in the human cornea after excimer laser in situ keratomileusis.
Excimer laser in situ keratomileusis was done in three human eyes 8 days, 54 days, and 4 months prior to enucleation. Acetylcholinesterase reaction was used to histochemically demonstrate the corneal nerves. Immunohistochemical methods were used to demonstrate the following wound healing proteins: cellular fibronectin, tenascin, transforming growth factor-beta 1, and alpha-smooth muscle actin.
All corneas healed without complication. No epithelial hyperplasia appeared and the Bowman's layer was smooth and acellular. An epithelial plug extending up to 100-300 microns under the flap margins was seen in all specimens. Regenerative nerve fiber bundles emerging from sharply cut anterior stromal nerves were observed, but the deeper nerves were normal. Restricted expression of fibronectin and tenascin was found at the wound area. All corneal cell types were positive for transforming growth factor-beta 1 antibody. Cells lining the limbal vessels were positive for alpha-smooth muscle actin antibody whereas the corneal cells were negative.
The nerve morphology showed only a few abnormalities, especially in deep stromal nerves. Epithelial plugs at the flap margins may maintain a delayed wound healing process for several months but otherwise the process remained active for a relatively short time.
我们的目的是描述准分子激光原位角膜磨镶术后人角膜的伤口愈合和神经再生情况。
在摘除眼球前8天、54天和4个月，对三只人眼进行准分子激光原位角膜磨镶术。采用乙酰胆碱酯酶反应组织化学法显示角膜神经。采用免疫组织化学方法显示以下伤口愈合蛋白：细胞纤维连接蛋白、腱生蛋白、转化生长因子-β1和α-平滑肌肌动蛋白。
所有角膜均愈合良好，无并发症。未见上皮增生，Bowman层光滑且无细胞。在所有标本中均可见上皮栓延伸至瓣边缘下方100 - 300微米处。观察到从前基质神经锐性切断处出现再生神经纤维束，但深层神经正常。在伤口区域发现纤维连接蛋白和腱生蛋白的表达受限。所有角膜细胞类型对转化生长因子-β1抗体均呈阳性。角膜缘血管内衬细胞对α-平滑肌肌动蛋白抗体呈阳性，而角膜细胞呈阴性。
神经形态仅显示少数异常，尤其是深层基质神经。瓣边缘的上皮栓可能使伤口愈合过程延迟数月，但除此之外，该过程在相对较短的时间内仍保持活跃。
