飞秒激光角膜基质透镜胶原交联后再利用的研究

角膜移植成功率较高，但需求者远超供体，因此提供稳定的供体至关重要。飞秒激光小切口角膜基质透镜取出术(SMILE)是近视治疗手术，术中完整地取出透镜。但透镜薄、硬度低、力量弱等问题而被丢弃。核黄素联合紫外光A诱导胶原交联可以增强角膜生物力学性能已用于防止医源性角膜扩张和早期圆锥角膜。本课题组前期研究结果显示：胶原交联可显著增强单片透镜的生物力学性能和抗水肿能力。因此推测透镜胶原交联后可再移植而提高其利用率和成功率。为此本课题进一步研究透镜胶原交联后：（1）交联程度与生物力学性能关系；（2）长期保存对透镜角膜基质细胞活性及透镜透明性的影响；（3）再移植对角膜生物力学性能和眼屈光的影响；（4）透镜移植治疗角膜穿孔对免疫性和组织愈合的影响。以期明确角膜透镜胶原交联在提高角膜生物力学同时是否有利于角膜的保存、降低角膜的免疫性，提高移植手术的成功率，为充分利用SMILE术后的大量透镜造福患者提供依据。

Corneal transplantation has a high success rate due to its relative immune privilege. However, the demand of corneal transplantation are much more than the corneal donors, so it is important to provide a stable cornea donor. Small Incision Lenticule Extraction (SMILE) is the main surgery to treat myopia and myopic astigmatism. However, due to the thinner lenticule, lower stiff, weak strength, most of the lenticule were discarded. And riboflavin combined with ultraviolet A induces corneal collagen crosslinking (CXL) to enhance the biomechanics of cornea and was used to prevent iatrogenic corneal dilatation and early keratoconus in clinic. Meanwhile preliminary study showed that collagen cross-linking could significantly enhance the biomechanics and anti-edema ability of single lenticule. Therefore, we speculated that the retransplantation of lenticule after inducing by CXL can effectively improve its utilization rate and success rate. So the further study of lenticule after CXL will be explored: (1) the correlation between the degree of CXL and biomechanics of lenticules; (2) the corneal stromal cell activity and transparency of lenticule induced by CXL after long-term preservation; (3) the effect of retransplantation on corneal biomechanics; (4)the effect on the immunity and tissue healing of the lenticule retransplantation to treat corneal perforation. The purpose is to clarify whether CXL is help to improve the biomechanics, preserve the lenticule, and decrease the corneal lenticule immunity and to provide theoretical basis to make full use of the lenticules after SMILE.