Organization of the Regenerated Nerves in Human Corneal Grafts
Organization of the Regenerated Nerves in Human Corneal Grafts
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DOI：
10.1016/j.ajo.2011.06.006
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发表时间：
2012-01-01
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 Ali;Otri, Ahmad Muneer;Dua, Harminder S.
目的：用组织病理学方法观察人角膜移植神经再生的程度，确定再生神经的解剖组织和形态。设计：实验实验室调查。方法：选取年龄34-93岁（平均66.9岁）的12例患者（男7例，女5例）的12例角膜移植。再移植最常见的指征是晚期内皮衰竭。移植物平均生存时间为6.41年（范围1-14年）。采用乙酰胆碱酯酶法对新获得的带有窄边缘宿主组织结合移植物-宿主连接的标本进行角膜神经鉴定。结果：75%的移植物周围区有基底下神经，25%的移植物中心区有基底下神经。它们大多来源于宿主的基底下神经。在83%的标本中检测到再生的基质神经；其中一半显示向移植物中心延伸。观察到基底下神经和间质神经之间缺乏正常的联系，几乎所有再生的间质神经都保留在间质内，不参与上皮神经支配。结论：人类角膜移植物在术后14年仍存在角膜神经的解剖破坏。这可以解释以前的研究报告中角膜感觉的显著减少。[J]中华眼科杂志，2012;33(3):391 - 391。(C) 2012年Elsevier Inc.版权所有。)
PURPOSE: To examine by histopathology the degree of nerve regeneration in human corneal grafts and to determine the anatomic organization and morphology of the regenerated nerves.DESIGN: Experimental laboratory investigation.METHODS: Twelve corneal grafts from 12 patients (7 men and 5 women) aged 34-93 (mean, 66.9 years) were included. The most common indication for regrafting was late endothelial failure. The mean duration of graft survival was 6.41 years (range, 1-14 years). The freshly obtained specimens with a narrow rim of host tissue incorporating the graft-host junction were subjected to the acetylcholinesterase method for the demonstration of corneal nerves.RESULTS: Subbasal nerves were found in 75% and 25% of the grafts at the periphery and center, respectively. They were mostly originated from the host sub-basal nerves. Regenerated stromal nerves were detected in 83% of the specimens; half of them showed extension into the center of the graft. A lack of the normal link between the subbasal and stromal nerves was observed and almost all of the regenerated stromal nerves were found to remain within the stroma and did not contribute to the epithelial innervation.CONCLUSIONS: A persistent anatomic disorganization of the corneal nerves in human grafts was found even 14 years after surgery. This could explain the significant reduction of corneal sensation reported in previous studies. (Am J Ophthalmol 2012;153:29-37. (C) 2012 by Elsevier Inc. All rights reserved.)