Kang S J, Kim E K, Kim H B
Departments of Ophthalmology, Sanggye Paik Hospital, Inje University, Seoul,
Ophthalmologica. 1999;213(1):20-4. doi: 10.1159/000027388.
We compared the corneal wound healing responses of keratomileusis and keratectomy in rabbits. A single pass of thin lamellar keratectomy was performed with a microkeratome in rabbits. The lenticule was repositioned with a hinge in one group and discarded in the other. With immunofluorescence techniques, we studied the appearance and distribution of fibronectin, fibrinogen and type III collagen at follow-up intervals from 1 h to 3 months. Fibronectin and fibrinogen began to deposit on the periphery of the denuded stroma 3 h after induced injury and diminished once reepithelialization had completed in both groups. In the corneas with attached lenticules, type III collagen was detected 7 days after surgery and lasted for at least 3 months. Type III collagen was detected only in the periphery of the interface and not in its center. These findings suggest that fibronectin and fibrinogen may play roles in epithelial healing after in situ keratomileusis in rabbits. Stromal healing of collagen seems to take place 7 days after keratomileusis and to last for several months. No deposits of new collagens in the center of the interface between lenticule and stromal bed may explain the optical clarity in the keratomileusis.
我们比较了兔角膜磨镶术和角膜切除术的角膜伤口愈合反应。用微型角膜刀在兔眼进行单次薄片状角膜切除术。一组将透镜瓣通过铰链重新定位，另一组则将其丢弃。采用免疫荧光技术，我们研究了从1小时到3个月的随访期间纤连蛋白、纤维蛋白原和III型胶原的出现情况及分布。两组中，诱导损伤后3小时，纤连蛋白和纤维蛋白原开始沉积在裸露基质的周边，上皮再形成完成后便减少。在透镜瓣附着的角膜中，术后7天检测到III型胶原，且持续至少3个月。III型胶原仅在界面周边检测到，而非在其中心。这些发现表明，纤连蛋白和纤维蛋白原可能在兔原位角膜磨镶术后的上皮愈合中发挥作用。角膜磨镶术后7天似乎发生了胶原的基质愈合，并持续数月。透镜瓣与基质床之间界面中心无新胶原沉积可能解释了角膜磨镶术的光学清晰度。
