神经生长因子滴眼液对兔眼准分子激光原位角膜磨镶术后角膜神经修复的影响VIP免费

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...