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准分子原位角膜磨镶术和准分子激光角膜切削术后角膜基质重塑伴角膜光散射

Corneal light scattering with stromal reformation after laser in situ keratomileusis and photorefractive keratectomy.

作者信息

Chang S W, Benson A, Azar D T

机构信息

Corneal and Refractive Surgery Services, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA.

出版信息

J Cataract Refract Surg. 1998 Aug;24(8):1064-9. doi: 10.1016/s0886-3350(98)80099-0.

DOI:10.1016/s0886-3350(98)80099-0
PMID:9719965
Abstract

OBJECTIVE

To correlate corneal light scattering with keratocyte and extracellular matrix reformation after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK).

SETTING

Wilmer Ophthalmological Institute, Johns Hopkins University, Baltimore, Maryland, USA.

METHODS

Sixteen pigmented rabbit eyes were randomly divided into 2 groups. Group 1 (n = 8) had a 5.0 mm, -10.0 diopter (D) LASIK treatment and Group 2 (n = 8), a 5.0 mm, -10.0 D surface PRK treatment after mechanical epithelial debridement. The stromal surface exposed at surgery was stained with dichlorotriazinylaminofluorescein (DTAF) solution. Slitlamp biomicroscopic and objective measurement of corneal light scattering using a scatterometer were performed 1 and 2 days and 1, 2, 3, 4, 8, and 12 weeks after surgery. In each group, 2 corneas were harvested at 1 week and 1 month and 4 corneas were harvested at 12 weeks. Tissue sections were examined by light and fluorescence microscopy. The percentage of newly formed stromal tissue was calculated and correlated with the scatterometry index.

RESULTS

In Group 1, corneas remained clear and healed without significant scarring throughout the study. In Group 2, subepithelial scarring was noted. Extracellular matrix reformation peaked at 1 month and showed a slight regression thereafter. The percentage of extracellular matrix reformation was strongly correlated with the scatterometry index (r = .86, P < .001).

CONCLUSIONS

In this study, significant subepithelial stromal tissue reformation followed PRK. The percentage of extracellular matrix reformation correlated well with the objective corneal light scattering measurements.

摘要

目的

将准分子原位角膜磨镶术(LASIK)和准分子激光屈光性角膜切削术(PRK)后角膜光散射与角膜细胞及细胞外基质重塑相关联。

设置

美国马里兰州巴尔的摩市约翰霍普金斯大学威尔默眼科研究所。

方法

16只色素沉着兔眼随机分为2组。第1组(n = 8)接受5.0毫米、-10.0屈光度(D)的LASIK治疗,第2组(n = 8)在机械性上皮刮除术后接受5.0毫米、-10.0 D的表面PRK治疗。手术中暴露的基质表面用二氯三嗪基氨基荧光素(DTAF)溶液染色。术后1天、2天以及1周、2周、3周、4周、8周和12周进行裂隙灯生物显微镜检查和使用散射仪客观测量角膜光散射。每组在1周和1个月时摘取2只角膜,在12周时摘取4只角膜。组织切片通过光镜和荧光显微镜检查。计算新形成的基质组织百分比并与散射测量指数相关联。

结果

在第1组中,整个研究过程中角膜保持清晰且愈合,无明显瘢痕形成。在第2组中,观察到上皮下瘢痕形成。细胞外基质重塑在1个月时达到峰值,此后略有消退。细胞外基质重塑百分比与散射测量指数密切相关(r = 0.86,P < 0.001)。

结论

在本研究中,PRK后出现明显的上皮下基质组织重塑。细胞外基质重塑百分比与客观角膜光散射测量结果良好相关。

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