第2期第10卷·屈光手术研究·第10卷第2期2008年3月眼视光学杂志ChineseJournalofOptometry&OphthalmologyVol.10No.2Mar.2008EffectoftopicalNGFoncornealnerveregenerationintherabbiteyeafterlaserinsitukeratomileusisDINGDongmei,CHENHui,SANGAimin,etal.DepartmentofOphthalmology,AffiliatedHospital,NantongUniversity,NantongChina,226001[Abstract]ObjectiveToinvestigatetheeffectofnervegrowthfactor(NGF)eyedropsonrabbitcornealnervereinnervationafterlaserinsitukeratomileusis.MethodsLaserinsitukeratomileusisformyopiawasperformedonbotheyesof35rabbitsandthen100!g/mlNGFeyedropswereusedonthelefteyesandabal-ancedsaltsolution(BSS)wasusedontherighteyes,onedrop,3timesaday.Aftertheanteriorandposteriorsegmentsoftheeyeballwereexamined,therabbitsweresacrificed1day,3days,1week,2weeks,1month,3months,and6monthspostopera-tivelyandthecorneaswereremovedforgoldenchloridestaining.TheeffectofNGFeyedropsoncornealnerveregenerationwasob-servedandcomparedbycountingthenumberofregeneratingcornealnervesbothintheepitheliumandinboththeshallowanddeepstromallayersatthedifferenttimeperiodsaftersurgery.Re-sultsNervefibersinthedeepandshallowstromaandthesubep-itheliumlocatedatthehingeofthecornealflapwerenotdamaged.However,thesubepithelialnerveplexusandshallowstromalnervesoutsidethehingeareaofthecornealflapwereabsentafterLASIK.Buddingnervefibersgrewtowardtheshallowstromaandregenerat-ingnervetrunksinthedeepstromacouldbeseenonthe3rddayafterLASIK.Someregeneratingnerveswereseeninthesubepithe-lialnerveplexusandtheshallowstromawithina1-monthperiodafterLASIK.Newnervesfromthedeepstromaformednetworksandapproachedtheshallowstromaat2months.Threemonthslater,regeneratednervesofthedeepstromahadconnectedintothesubepithelialnerveplexus.Thenervesintheperipheralcorneashowedcompleterecovery,butnonervefiberswereseeninthecentralcorneaat6months.TherewasasignificantdifferenceinthenumberofregeneratingnervesinthecornealepitheliumandtheshallowanddeepstromallayerswhentheNGFgroupandBSSgroupwerecomparedatdifferentperiodsaftersurgery(P<0.05).TherewasahighernumberofregeneratingcornealnervesintheNGFgroupthanintheBSSgroup.ConclusionNGFeyedropscanacceleratecornealnerveregenerationandreinnervationatdifferentperiodsafterLASIK.[Keywords]keratomileusis;laserinsitu/methods;rabbit;nervegrowthfactor;cornealnerve;nerveregeneration[摘要]目的观察神经生长因子(nervegrowthfactor,NGF)滴眼液对兔眼准分子激光原位角膜磨镶术(laserinsitukeratomileusis,LASIK)后角膜神经修复的影响。方法35只中华大耳白兔双眼接受近视性LASIK术,术后左眼用配置的100!g/mlNGF滴眼液,右眼滴平衡液(balancedsaltsolution,BSS)作为对照,1滴/次,3次/d。分别于术后第1天、第3天、第1周、第2周、第1个月、第3个月、第6个月各取5只兔,在观察双眼前后节反应后处死兔,摘除双侧角膜,进行角膜神经氯化金染色。光镜下观察LASIK术后角膜神经修复过程,分别比较角膜上皮、浅基质层,深基质层NGF组与BSS组LASIK术后不同时期角膜神经的数量。结果LASIK术后角膜深基质层、角膜瓣连接处的上皮下和浅基质层神经未受损,瓣切削处上皮下和浅基质层神经消失。术后不同部位的角膜神经再生程度不同,术后第6个月周边部角膜神经形态已接近正常,角膜中央仍无神经分布。NGF组与BSS组术后各时间点角膜上皮、浅基质层神经数量比较,NGF组大于BSS组,差异有显著性(P<0.05);两组术后深基质层神经数量比较,NGF组大于BSS组,差异也有显著性(P<0.05)。结论NGF滴眼液对LASIK术后不同部位、不同时期角膜神经的修复有明显促进作用。[关键词]角膜磨镶术,激光原位/方法;兔;神经生长因子;角膜神经;神经再生[中图分类号]R779.63[文献标识码]A...
