国际眼科杂志2007，Vol.7Issue(3)：635-641,7.
羊膜移植术在碱烧伤急性期重建结膜表面的实验研究
The effect of amniotic membrane transplantation on rabbit conjunctival surface reconstruction at the recovering stage of alkali burn
许军 1赵江月 1辛容 2王洪学 3徐艳春 4张劲松1
作者信息
- 1. 110005,中国辽宁省沈阳市,中国医科大学附属第四医院眼科
- 2. 加拿大圣约翰斯市,加拿大纽芬兰纪念大学病理科
- 3. 134300,中国吉林省白山市,吉林省白山市八道江区医院眼科
- 4. 110001,中国辽宁省沈阳市,中国医科大学附属第一医院眼科
- 折叠
摘要
Abstract
AIM: (1) To investigate the effect of amniotic membrane transplantation (AMT) on rabbit conjunctival surface reconstruction with severe alkali burns. (2) To evaluate the possibility of AMT treatment for ocular alkali burns during recovering stage.METHODS: Animal models were established on 30 eyes of rabbits by creating severe alkali burns on the conjunctiva from the upper corneal limbus to the upper conjunctival fornix.Preserved human amniotic membrane transplantations and reconstruction of conjunctival fornix were performed at one week after injury (recovering stage). Epithelium growth of burned area after transplantation was observed using light microscope at 1, 2, 3, 4, and 8 weeks. Conjunctival tissue in transplantation area was collected at 1, 4 and 8 weeks. The ultrastructure of the collected tissue was studied by electron microscope. The results were compared with control group,which received only vitamin C subconjunctival injection and antibiotic eye drops as treatment for alkali burn. Exterior eye pictures were also taken at the end of the observation, the width from upper corneal limbus to the edge of upper fornix was measured. Data was analyzed statistically.RESULTS: 1) Tn the transplant group, conjunctival epithelium growth was observed in the area of AMT under both light and electron microscope 1 week after surgery. At 4weeks, conjunctival epithelium with goblet cells that resembled normal conjunctival tissues was observed in the whole amniotic membrane area. At 12 weeks, the conjunctival epithelium on the amniotic membrane was well formed, and the connective tissue under the epithelium was loose at the fornix. No fibrosis was identified. In contrast, conjunctival epithelium necrosis was observed in the control group at 2weeks after alkali burns. Re-epithelization did not occur through the 12-week observation. Severe fibrosis with inflammatory cells infiltration was observed between 4 to 8weeks. At 12 weeks, fibrosis of the connective tissue at the fornix developed and there were no conjunctival epithelium covering the burned area. 2) In the transplant group, the conjunctiva in transplanted area had no scarring and appeared smooth at 12 weeks. Upper fornix was reconstructed. The depth of fornix was 7.9±0.3mm (7.6-8.2mm), which was approximate to the normal depth 8.2±0.2mm (8.0-8.4 mm,P＞.05). While in the control group, the burned area appeared rough with granuloma formation and severe scarring. Upper fornix became shallow. The depth of fornix was 3.1±1.7mm(1.0 to 4.5mm.), and significant difference was found between control and transplant group (P＜0.01).CONCLUSION: Human amniotic membrane preserved in glycerin can promote cell adhering, migrating and differentiating of normal conjunctival epithelium.Reconstruction of conjunctival surface in early stage of alkali burn can be achieved by AMT. AMT can effectively prevent symblepharon formation.关键词
结膜/眼化学伤/羊膜移植/兔Key words
conjunctiva/chemical burn/amniotic membrane transplantation/rabbit分类
医药卫生引用本文复制引用
许军,赵江月,辛容,王洪学,徐艳春,张劲松..羊膜移植术在碱烧伤急性期重建结膜表面的实验研究[J].国际眼科杂志,2007,7(3):635-641,7.
