The Effect of Standard and Transepithelial Ultraviolet Collagen Cross-Linking on Human Corneal Nerves: An Ex Vivo Study
The Effect of Standard and Transepithelial Ultraviolet Collagen Cross-Linking on Human Corneal Nerves: An Ex Vivo Study
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DOI：
10.1016/j.ajo.2011.07.006
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发表时间：
2012-02-01
影响因子：
4.2
通讯作者：
Dua, Harminder S.
中科院分区：
文献类型：
--
作者：
Al-Aqaba, Mouhamed;Calienno, Roberta;Dua, Harminder S.
目得：评估标准和经上皮胶原交联对供体眼角膜神经的早期影响，通过离体共聚焦显微镜和乙酰胆碱酯酶染色。设计：实验室调查。方法：包括8个人眼库角膜按钮（平均年龄，73.6岁）。在3个角膜上用涉及上皮清创的标准方案进行死后紫外线A胶原交联，并通过经上皮方法对4个角膜进行死后紫外线A胶原交联。一个角膜作为对照。角膜神经进行了评估，共聚焦显微镜和乙酰胆碱酯酶histology.RESULTS：共聚焦显微镜显示，在标准技术处理的角膜基底下神经的情况下。这些神经被保存在经上皮途径治疗的角膜中。两组间质神经均可见。通过标准技术治疗的角膜的组织学显示了基质神经的局部硬化，伴有轴突膜的破坏和治疗区内轴突连续性的丧失。这些变化是不存在的transepithelial approach.CONCLUSIONS：本研究强调了在离体模型的角膜神经胶原交联的直接影响。在治疗的早期阶段，基底下神经的缺失似乎主要归因于上皮的机械去除，而不是紫外线诱导的损伤。间质神经的局部肿胀是两种治疗方案之间的主要差异。有必要对实验室动物进行进一步研究，以验证在特定时间过程中的这些变化，而不需要额外增加死后变化。(Am J Ophthalmol 2012;153：258-266. (C)2012年，Elsevier Inc.版权所有© 2016
PURPOSE: To evaluate the early effect of standard and transepithelial collagen cross-linking on human corneal nerves in donor eyes by ex vivo confocal microscopy and acetylcholinesterase staining.DESIGN: Experimental laboratory investigation.METHODS: Eight human eye bank corneal buttons (mean age, 73.6 years) were included. Ultraviolet A collagen cross-linking was performed postmortem on 3 corneas with the standard protocol involving epithelial debridement and 4 corneas by the transepithelial approach. One cornea served as a control. Corneal nerves were evaluated using confocal microscopy and acetylcholinesterase histology.RESULTS: Confocal microscopy demonstrated the absence of subbasal nerves in corneas treated by the standard technique. These nerves were preserved in corneas treated by the transepithelial approach. Stromal nerves were visible in both groups. Histology of corneas treated by the standard technique revealed localized swellings of the stromal nerves with disruption of axonal membrane and loss of axonal continuity within the treatment zone. These changes were absent in corneas treated by the transepithelial approach.CONCLUSIONS: This study highlights the immediate effects of collagen cross-linking on the corneal nerves in an ex vivo model. The absence of subbasal nerves in the early phase of treatment appears to be attributable mainly to mechanical removal of epithelium, rather than ultraviolet light induced damage. Localized swelling of the stromal nerves was the main difference between the 2 treatment protocols. Further research on laboratory animals would be necessary to verify these changes over a specified time course without the super-addition of postmortem changes. (Am J Ophthalmol 2012;153:258-266. (C) 2012 by Elsevier Inc. All rights reserved.)