[新世界猴角膜表面切除术后角膜创面愈合:Er: yag -准分子激光]。

G Kahle, X Daqun, T Seiler, C Schröter-Kermani, J Wollensak
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引用次数: 0

摘要

研究了准分子激光(193 nm, 43脉冲,180 mJ/cm2[符号:见文]11微米烧蚀深度,光学区2.0 mm)和铒钇铝石榴石激光(2.94微米,5脉冲,2.5 J/cm2[符号:见文]50微米烧蚀深度,光学区1.6 mm)光消融后角膜创面愈合情况。分别在光消融后第5、10天和第4、25周制备狨猴角膜。切片用常规光镜观察或暴露于I、III、IV、VII型胶原和层粘连蛋白抗体中,并用间接免疫荧光染色。从宏观上看,创面愈合的时间过程与人类激光角膜磨砂术后相当(24-48小时后上皮闭合,上皮下混浊:铒- yag小于或等于准分子)。组织学上,创面愈合过程大致可分为三个阶段:(1)上皮增生,上皮下胶原原纤维不均匀合成;(2)上皮重组,角化细胞增生,胶原原纤维早期重组,上皮下混浊增加;(3)胶原原纤维重组,上皮下混浊减少。VII型胶原在角膜创面愈合过程中的分布表明,激光角膜磨砂术矫正近视后愈合过程中观察到的上皮下雾是基于基底膜的锚定原纤维。
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[Wound healing of the cornea of New World monkeys after surface keratectomy: Er:YAG-excimer laser].

Corneal wound healing was studied after photoablation with an excimer laser (193 nm, 43 pulses at 180 mJ/cm2 [symbol: see text] 11 microns ablation depth, optical zone 2.0 mm) and with an erbium-YAG laser (2.94 microns, 5 pulses at 2.5 J/cm2 [symbol: see text] 50 microns ablation depth, optical zone 1.6 mm). The corneas of marmosets (Callithrix jacchus) were prepared 5 and 10 days and 4 and 25 weeks after photoablation. The sections were investigated by conventional light microscopy or exposed to antibodies against collagen types I, III, IV, VII and laminin and stained by indirect immunofluorescence. Macroscopically, the time-course of wound healing was comparable to that seen, after laser keratomileusis for correction of myopia in humans (epithelium closure after 24-48 h, subepithelial haze: erbium-YAG less than or equal to excimer). Histologically the time-course of wound healing could be schematically divided into three phases: (1) epithelial hyperplasia, inhomogeneous new synthesis of collagen fibrils subepithelially; (2) reorganization of the epithelium, hyperplasia of keratocytes, incipient reorganization of the collagen fibrils, increase in subepithelial haze; (3) reorganization of the collagen fibrils, decrease in subepithelial haze. The distribution of collagen type VII during the corneal wound healing suggests that the subepithelial haze observed during the healing process after laser keratomileusis for correction of myopia is based on the anchoring fibrils of the basement membrane.

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