O'Brien T P, Li Q, Ashraf M F, Matteson D M, Stark W J, Chan C C
Cornea Service, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Md., USA.
Arch Ophthalmol. 1998 Nov;116(11):1470-4. doi: 10.1001/archopht.116.11.1470.
To evaluate the inflammatory response and its potential role in the early stages of corneal wound healing after excimer laser keratectomy.
Lewis rats underwent excimer keratectomy using a 193-nm excimer laser. The central corneas were ablated in 3 depths: group A, epithelium; group B, superficial stroma; or group C, deep stroma. Eyes were harvested 1, 12, 24, and 36 hours, and 1 week after the rats were killed. Immunohistochemistry was used to test frozen sections with monoclonal antibodies of various inflammatory cellular markers.
Reepithelialization was observed at 12 hours in group A, and at 24 hours in groups B and C. Regenerated epithelium covered the denuded corneal surface in groups B and C after 1 week. The expression of major histocompatibility complex II antigen was detected in infiltrating cells, corneal epithelial cells, and endothelial cells 1 hour after surgery. Only a few macrophages and Langerhans cells were in the limbus at baseline. Macrophages migrated from the limbus to the corneal ablation zone and increased 2-fold after 36 hours in all 3 groups compared with baseline. Occasional lymphocytic infiltration was identified after 25 to 36 hours.
Macrophages play an active role in the wound healing after laser keratectomy and may contribute to transient corneal haze.
评估准分子激光角膜切削术后角膜伤口愈合早期的炎症反应及其潜在作用。
对Lewis大鼠使用193nm准分子激光进行角膜切削术。将中央角膜切削至3种深度：A组，上皮层；B组，浅基质层；C组，深基质层。在大鼠处死1、12、24和36小时以及1周后摘取眼球。采用免疫组织化学方法，用多种炎症细胞标志物的单克隆抗体检测冰冻切片。
A组在12小时观察到上皮再形成，B组和C组在24小时观察到。1周后，B组和C组再生上皮覆盖了裸露的角膜表面。术后1小时在浸润细胞、角膜上皮细胞和内皮细胞中检测到主要组织相容性复合体II类抗原的表达。基线时仅在角膜缘有少量巨噬细胞和朗格汉斯细胞。巨噬细胞从角膜缘迁移至角膜切削区，与基线相比，3组在36小时后均增加了2倍。在25至36小时后发现偶尔有淋巴细胞浸润。
巨噬细胞在激光角膜切削术后的伤口愈合中起积极作用，可能导致短暂性角膜混浊。
