Early Corneal Wound Healing and Inflammatory Responses after Refractive Lenticule Extraction (ReLEx)
Early Corneal Wound Healing and Inflammatory Responses after Refractive Lenticule Extraction (ReLEx)
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DOI：
10.1167/iovs.11-7439
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发表时间：
2011-08-01
影响因子：
4.4
通讯作者：
Mehta, Jodhbir S.
中科院分区：
文献类型：
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作者：
Riau, Andri K.;Angunawela, Romesh I.;Mehta, Jodhbir S.
目的。比较屈光小晶状体摘除术（ReLEx）和lasik术后早期角膜创面修复及炎症反应。18只兔子接受了ReLEx手术，另外18只接受了LASIK手术。每组分为3个亚组，每组6只兔，术后1天进行裂隙灯摄影、前段光学相干断层扫描（AS-OCT）、角膜地形图和体内共聚焦显微镜检查，分别进行-3.00屈光度(D)、-6.00 D和-9.00 D屈光校正。安乐死后，对角膜进行纤维连接蛋白、CD11b、Ki-67免疫荧光染色和TUNEL检测。在裂隙灯显微镜下，ReLEx眼和LASIK眼的所有角膜在术前和术后都清晰。角膜地形图显示，随着矫正程度的增加，LASIK术后角膜变平比ReLEx术后更为显著（-3.00 D矫正后P = 0.916, -9.00 D矫正后P = 0.097）。体内共聚焦显微镜显示，ReLEx术后皮瓣界面的光散射粒子比LASIK少。纤维连接蛋白的免疫染色显示，与LASIK相比，松弛角膜的纤维连接蛋白表达较少。随着校正功率的增加，差异变得更加明显。cd11b阳性细胞的数量也出现了类似的趋势（-3.00 D校正后P = 0.476, -9.00D校正后P < 0.001）。放光后和未放光的眼在细胞死亡和增殖方面无明显差异。这项研究表明，与LASIK相比，ReLEx手术可能导致更少的地形变化、炎症和早期细胞外基质沉积，特别是在高屈光矫正时。（Invest Ophthalmol Vis Sci. 2011; 52: 6213-6221） DOI: 10.1167/iovs.11-7439
PURPOSE. To compare the early corneal wound repair and inflammatory responses after refractive lenticule extraction (ReLEx) and LASIK.METHODS. Eighteen rabbits underwent ReLEx and another 18 underwent LASIK. Each group was divided into three subgroups of six rabbits each and these were subjected to refractive corrections of -3.00 diopters (D), -6.00 D, and -9.00 D. Slit lamp photography, anterior segment optical coherence tomography (AS-OCT), corneal topography, and in vivo confocal microscopy were performed 1 day after surgery. After euthanatization, the corneas were subjected to immunofluorescent staining for fibronectin, CD11b, Ki-67, and TUNEL assay.RESULTS. On slit lamp microscopy, all corneas appeared clear pre- and postoperatively in both ReLEx and LASIK eyes. Corneal topography showed a more significant corneal flattening after LASIK than after ReLEx as the degree of correction was increased (P = 0.916 after -3.00 D correction to P = 0.097 after -9.00 D correction). In vivo confocal microscopy showed less light-scattering particles at the flap interface after ReLEx compared with LASIK. Immunostaining of fibronectin showed a less abundant expression in corneas that underwent ReLEx than LASIK. The differences became more marked as the power of correction was increased. Similar trend was seen in the number of CD11b-positive cells (P = 0.476 after -3.00 D correction to P < 0.001 after -9.00D correction). There was no marked disparity observed in cell death and proliferation between post-ReLEx and -LASIK eyes.CONCLUSIONS. This study has shown that the ReLEx procedure may result in less topographic changes, inflammation, and early extracellular matrix deposition than LASIK, especially at high refractive correction. (Invest Ophthalmol Vis Sci. 2011; 52: 6213-6221) DOI: 10.1167/iovs.11-7439