Two-year observation of morphologic and histopathologic changes in the monkey cornea following small incision allogenic lenticule implantation
Two-year observation of morphologic and histopathologic changes in the monkey cornea following small incision allogenic lenticule implantation
复制标题
小切口同种异体微透镜植入后猴角膜形态和组织病理学变化的两年观察
DOI：
10.1016/j.exer.2020.107935
复制
发表时间：
2020-03-01
影响因子：
3.4
通讯作者：
Zhou, Xingtao
中科院分区：
文献类型：
--
作者：
Zhao, Jing;Liu, Rui;Zhou, Xingtao
目的：观察飞秒激光辅助小切口同种异体基质内透镜植入术（AILI）在猴角膜中的形态学和组织病理学变化。
方法：纳入6只健康成年猴。2只猴的单眼以及1只猴的双眼接受了矫正度数为 -4.0屈光度（D）的飞秒透镜取出术。每个取出的屈光供体透镜立即同种异体移植到另一只猴眼中由飞秒激光制作的角膜基质袋内。术后进行为期两年的随访，采用裂隙灯显微镜、角膜地形图、眼前段光学相干断层扫描以及活体共聚焦显微镜检查。所有眼球摘除后进行苏木精 - 伊红染色和透射电子显微镜（TEM）观察。
结果：随访期间未观察到并发症。术后2年，裂隙灯显微镜下角膜保持透明，透镜与周围组织融合。通过共聚焦显微镜观察到透镜层有神经纤维再生。2年后角膜屈光力增加了1.83±1.36 D，低于6个月时（3.27±1.2 D）。光镜和TEM下可检测到植入透镜内纤维紊乱以及角膜细胞减少，透镜与周围组织边界清晰。
结论：小切口AILI用于角膜重塑是可行且安全的。术后2年内角膜愈合保持稳定，而屈光呈现适度回退。
Purpose: To observe the morphologic and histopathologic changes of femtosecond laser assisted small incision allogenic intrastromal lenticule implantation (AILI) in monkey corneas.Methods: 6 healthy adult monkeys were included. One eye of two monkeys and both eyes of one monkey received femtosecond lenticule extraction with a -4.0 diopter (D) correction. Each extracted refractive donor lenticule was immediately allogeneically transplanted into a corneal stromal pocket created by a femtosecond laser in another monkeys eye. A postoperative two-year follow-up was performed with slit lamp microscopy, corneal topography, anterior segment optical coherence tomography and in vivo confocal microscopy. All eyes were enucleated for Hematoxylin-Eosin staining and transmission electron microscopy (TEM) observation.Results: No complications were observed in the follow-up period. At postoperative 2 years, the corneas remained clear and the lenticules were integrated with the surrounding tissue under slit lamp microscopy. Nerve fiber regeneration was detected in the lenticule layer as observed through confocal microscopy. Corneal power was increased by 1.83 +/- 1.36 D after 2 years, which was less than at 6 months (3.27 +/- 1.2 D). Disordered fibers and decreased keratocytes in the implanted lenticules could be detected under light microscopy and TEM, with a clear boundary between the lenticules and the surrounding tissue.Conclusions: Small incision AILI is feasible and safe for reshaping the cornea. Corneal healing remained stable while refraction showed a moderate regression within postoperative 2 years.