Apoptosis, necrosis, proliferation, and myofibroblast generation in the stroma following LASIK and PRK
Apoptosis, necrosis, proliferation, and myofibroblast generation in the stroma following LASIK and PRK
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DOI：
10.1016/s0014-4835(02)00251-8
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发表时间：
2003-01-01
影响因子：
3.4
通讯作者：
Wilson, SE
中科院分区：
文献类型：
--
作者：
Mohan, RR;Hutcheon, AEK;Wilson, SE
本研究的目的是半定量分析接受屈光性角膜切除术 (PRK) 或激光原位角膜磨镶术 (LASIK) 的兔眼在 4 小时至 3 个月的时间点内的基质细胞凋亡、基质细胞增殖和肌成纤维细胞生成。还研究了基质细胞坏死和炎症细胞浸润。对兔眼进行低度近视PRK（-4.5屈光度[D]）、高度近视PRK（-9.0D）和高度近视LASIK（-9.0D），并在术后4、24、72小时、1、4周和3个月时取角膜进行检查。该研究共有 144 只兔子。分别通过 TUNEL 测定、M67 免疫细胞化学分析和 α-平滑肌肌动蛋白免疫细胞化学分析对基质细胞凋亡、增殖和肌成纤维细胞生成进行半定量评估。通过电子显微镜评估基质细胞坏死和基质中其他细胞类型的特征。与低度近视的 PRK 或高度近视的 LASIK 相比，高度近视的 PRK 中角膜细胞凋亡以及随后的肌成纤维细胞增殖和生成在质量和数量上都有所不同。损伤后 24 小时，基质细胞坏死成为细胞死亡的一种重要形式，可能涉及角膜成纤维细胞、肌成纤维细胞和炎症细胞。术后24小时，大量多形核细胞和单核细胞侵入角膜，并持续1周以上。高度近视和低度近视 PRK 以及高度近视 LASIK 后细胞伤口愈合反应的定性和定量差异可能是屈光结果临床差异以及这些手术后出现的一些并发症（例如退化和混浊）的决定因素。 (C) 2002 年，爱思唯尔科学有限公司出版。
The aim of this study was to semi-quantitatively analyze stromal cell apoptosis, stromal cell proliferation, and myofibroblast generation over time points from 4 hr to 3 months in rabbit eyes having photorefractive keratectomy (PRK) or laser in situ keratomeliusis (LASIK). Stromal cell necrosis and inflammatory cell infiltration were also studied. PRK for low myopia (-4.5 diopters [D]), PRK for high myopia (-9.0 D), and LASIK for high myopia (-9.0 D) were performed in rabbit eyes, and corneas were obtained for examination at 4, 24, and 72 hr, 1 and 4 weeks, and 3 months after surgery. A total of 144 rabbits were included in the study. Stromal cell apoptosis, proliferation, and myofibroblast generation were evaluated semi-quantitatively by TUNEL assay, immunocytochemical analysis of M67, and immunocytochemical analysis of alpha-smooth muscle actin, respectively. Stromal cell necrosis and characteristics of other cell types in the stroma were evaluated by electron microscopy. Keratocyte apoptosis and the subsequent proliferation and generation of myofibroblasts were qualitatively and quantitatively different in PRK for high myopia compared to either PRK for low myopia or LASIK for high myopia. Stromal cell necrosis becomes a significant form of cell death by 24 hr after injury and may involve corneal fibroblasts, myofibroblasts, and inflammatory cells. Large numbers of polymorphonuclear cells and monocytes invade the cornea by 24 hr after surgery and persist for over 1 week. The qualitative and quantitative differences in the cellular wound healing response after PRK for high and low myopia and LASIK for high myopia are likely determinants of the clinical differences in refractive outcome and some of the complications, such as regression and haze, seen after these procedures. (C) 2002 Published by Elsevier Science Ltd.