Ghosh F, Juliusson B, Arnér K, Ehinger B
Department of Ophthalmology, University of Lund, Sweden.
Exp Eye Res. 1999 Jan;68(1):67-74. doi: 10.1006/exer.1998.0582.
Adult and embryonic rabbit retinal sheets were transplanted into the subretinal space of adult rabbits. The transplants were either full-thickness with intact layering, or gelatin embedded and vibratome sectioned with the inner retina removed. The full-thickness grafts were positioned subretinally by means of a glass capillary in which they were partially folded. The vibratome sectioned ones were placed using a plastic injector in which the gelatin embedded graft was flat. The embryonic full-thickness grafts were followed clinically up to 3 months, and the other 3 transplant types up to 1 month postoperatively, after which the retina was sectioned and stained for light microscopy. Surgical complications were more common in eyes receiving vibratome sectioned grafts with 10 out of 34 eyes displaying blood in the vitreous. Four of these eyes also developed total retinal detachment. Out of 17 eyes receiving full-thickness grafts, only one displayed these complications. Histologically, 11 out of 13 embryonic full-thickness transplants revealed straight, laminated transplants with correct polarity, and with all normal retinal layers present. In these transplants, fusion with the host increased in time. Of the adult full-thickness transplants, only 1 out of 4 survived, and this graft showed signs of degeneration. The vibratome sectioned adult transplants in a few cases survived the first two postoperative weeks. In these grafts, both inner and outer retina were present, indicating an incomplete vibratome sectioning. With longer postoperative times, the number of surviving transplants in this group diminished considerably. All vibratome sectioned embryonic transplants developed into rosettes and sometimes also into laminated sections with reversed polarity. It can be concluded that in rabbits, the surgical technique used for vibratome sectioned transplants requires a larger sclerotomy and retinotomy, since they have to be kept flat in the transplanting instrument due to the surrounding gelatin. This technique is associated with a higher frequency of complications than the one used for full-thickness grafts which are more flexible and can be transplanted with a smaller instrument. Vibratome sectioning of embryonic grafts results in abnormal morphology and their adult counterparts only survive if the sectioning is incomplete. Adult full-thickness grafts show poor survival. Embryonic full-thickness transplants in the majority of cases develop into laminated retinas with layers parallel to the host retinal pigment epithelium. They also survive and integrate well with the host retina.
将成年和胚胎兔视网膜片移植到成年兔的视网膜下间隙。移植片要么是具有完整分层的全层，要么是包埋在明胶中，用振动切片机切片并去除内视网膜。全层移植物通过玻璃毛细管置于视网膜下，移植物在毛细管中部分折叠。用塑料注射器放置振动切片机切片的移植物，包埋在明胶中的移植物在注射器中是平的。对胚胎全层移植物进行临床随访长达3个月，对其他3种移植类型随访至术后1个月，之后将视网膜切片并进行光镜染色。手术并发症在接受振动切片机切片移植物的眼中更为常见，34只眼中有10只在玻璃体中出现血液。其中4只眼还发生了完全性视网膜脱离。在接受全层移植物的17只眼中，只有1只出现了这些并发症。组织学上，13个胚胎全层移植物中有11个显示出笔直的、分层的移植物，极性正确，所有正常视网膜层均存在。在这些移植物中，与宿主的融合随时间增加。在成年全层移植物中，4个中只有1个存活，且该移植物显示出退变迹象。振动切片机切片的成年移植物在少数情况下在术后前两周存活。在这些移植物中，内、外视网膜均存在，表明振动切片机切片不完全。随着术后时间延长，该组中存活移植物的数量显著减少。所有振动切片机切片的胚胎移植物均形成玫瑰花结，有时还形成极性反转的分层切片。可以得出结论，在兔中，用于振动切片机切片移植物的手术技术需要更大的巩膜切开术和视网膜切开术，因为由于周围的明胶，它们在移植器械中必须保持平坦。与用于全层移植物的技术相比，该技术并发症发生率更高，全层移植物更灵活，可以用较小的器械进行移植。胚胎移植物的振动切片会导致形态异常，其成年对应物只有在切片不完全时才能存活。成年全层移植物存活率低。大多数情况下，胚胎全层移植物会发育成与宿主视网膜色素上皮平行的分层视网膜。它们也能存活并与宿主视网膜良好整合。
