摘要
目的探讨准分子激光角膜上皮瓣下磨镶术(LASEK)中乙醇对角膜伤口愈合过程的影响。方法24只健康白兔(48只眼)分为两组,一只眼行机械去上皮法,另一只眼应用20%乙醇30s去除角膜上皮,行相同方案的准分子激光切削,同时设立正常对照组。观察角膜基质浅层角膜细胞数量和形态变化;RTPCR法及免疫组化法检测正常对照组及手术组术后1d、1周、1个月、3个月转化生长因子β1(TGFβ1)和碱性成纤维细胞生长因子(bFGF)的表达情况并做分析。结果术后1d,乙醇组和机械组兔角膜TGFβ1和bFGFRTPCR表达较正常对照组下降;1周两组较正常对照组升高(P<0.01),乙醇组高于机械组(P<0.01);术后1个月达高峰(P<0.01),但乙醇组与机械组比较差异无统计学意义(P>0.05);术后3个月,TGFβ1、bFGFRTPCR产物明显下降,两组之间比较或与正常对照组比较差异无统计学意义(P>0.05)。浅层基质内角膜细胞数量乙醇组与TGFβ1和bFGF的相关系数分别为0.744,0.738;机械组分别为0.664和0.785。结论TGFβ1、bFGF在伤口愈合过程中的表达呈现“减少增多正常”动态过程;20%乙醇在LASEK早期对角膜伤口愈合存在一定影响,但极其短暂。手术中应用是相对安全的。
Objective To assess the effects of 20% ethanol used in LASEK on corneal wound healing. Methods Forty-eight eyes from 24 rabbits were deepithelialized by two techniques. The epithelium were detached with either 20% ethanol (applied for 30 seconds) or mechanical scraping, then ablated was performed. The number of superficial stromal keratocytes was counted and the morphologic changes were observed. Expression of TGF-β1 and bFGF mRNAs was detected and analyzed by reverse transcription-polymerase chain reaction and immunocytochemical methods at 1, 7, 30 and 90 days after the surgery. Results One day after the surgery, the expression of TGF-β1 and bFGF in the keratocytes in both treated groups was lower than that of the normal controls. Seven days after the surgery, the expression of TGF-β1 and bFGF in both treated groups was greater than that of the normal controls (P<0.01). The expression in the alcohol-treated group was greater than that of the surgical-treated group (P<0.01). The expression of TGF-β1 and bFGF reached the peak 30 days after the surgery, no significant difference was detected between the alcohol-treated and surgical-treated groups. There was no significant difference in expression level between the alcohol-treated and surgical-treated groups 3 months after the surgery; as well as between treated groups and normal group. The amount of TGF-β1 and bFGF mRNA was positively correlated with the number of keratocytes. The correlation coefficient between TGF-β1 and bFGF mRNA and the number of the keratocytes was 0.744 (P<0.01) and 0.738 (P<0.01) in the alcohol-treated group; and was 0.664 (P<0.01) and 0.785 (P<0.01) in the surgical-treated group, respectively. Conclusions The expression of TGF-β1 and bFGF mRNA undergo a dynamic process of “decrease-increase-normal”. Although ethanol has a slight toxic effect on rabbit epithelial cells, but the effects do not persist over time, therefore, it is relatively safe to use the alcohol treatment in the LASEK.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2005年第6期498-504,共7页
Chinese Journal of Ophthalmology
基金
天津市自然科学基金资助项目(003611211)
