摘要
目的比较α-氰基丙烯酸酯医用胶和常规缝线对兔角膜穿孔伤愈合的影响。方法在24只新西兰白兔的双眼近角膜缘处作一长5 mm的切口,左眼用α-氰基丙烯酸酯封闭伤口,右眼用10-0尼龙线间断缝合,利用激光共焦显微镜观测术后7、15、30、60 d穿孔伤处兔角膜的愈合情况,并比较2组角膜新生血管(CNV)的生长。结果术后7 d内2组兔角膜伤口均闭合。实验组上皮细胞沿伤口表面胶膜边缘生长,对照组角膜伤口表面上皮细胞覆盖。术后15 d,实验组部分胶膜脱落,伤口上皮化。术后30 d,2组角膜基质层瘢痕增生,部分角膜见CNV。术后60 d,2组伤口处基质胶原连接成网状,前弹力层瘢痕愈合。术后7 d实验组的上皮细胞密度小于对照组,差异有统计学意义(P<0.05)。其余实验组角膜伤口的各层细胞密度与对照组比较,差异均无统计学意义(P>0.05)。术后60 d,记录2组CNV长入的兔眼数,利用Robert电脑公式对2组角膜CNV面积进行计算,经统计学分析,实验组CNV的出现率和平均CNV面积均低于对照组,两者差异均有统计学意义(P<0.05)。结论α-氰基丙烯酸酯封闭兔眼角膜穿孔伤口,对角膜伤口的愈合无明显的长期影响,可抑制CNV的生长。
Objective The corneal penetrating injury is one of the most frequent injuries in the ocular trauma. The rational regimen should be made promptly for remaining the useful vision result. This study aimed at comparing the repairing effectiveness of α-alkyl cyanoacrylate adhesive and polyglactine thread suture for corneal perforating injury in rabbits by laser confocal microscope. Methods A 5 mm of corneal perforating incision was taken in the bilateral eyes of 24 adult New Zealand white rabbits. The α-alkyl cyanoacrylate synthetic adhesive was used to adhere the wound in the left eyes and interruptedly sutured the wound with 10-0 polyglactine thread in the control group. The corneal wound healing was examined under the laser confocal microscope in 7,15,30,60 days after surgery. After 60 days, the area of corneal neovascularization （CNV） was calculated based on the Robert formula：S = C/12 × 3. 14 × [ r^2 - （r- l）^2]. Results The corneal wound was closed,and corneal scar was seen in postoperative 7 days under the slim lamp. The number of the epithelial cells was significantly less in adhesive group than in suturing group on 7 days postoperatively （P 〈 0.05）. Corneal epithelial cells grew along the adhesive membrane edge in α-alkyl cyanoacrylate synthetic adhesive group;while epithelial cells in suturing group covered the wound. In 15 days after operation,the adhesive membrane fell off and wound showed the epithelization in adhesive group. On the postoperative 30 days, the scars proliferated toward the stroma and corneas. CNV was seen in both groups. But, a great number of reductus and dark stripes appeared in corneal stroma in suturing group. Sixty days later, the reductus and dark stripes still existed in whole stroma in suturing group. The collagen connected into mesh in stroma, and the Bowman＇ s layer presented the scaring, and the incidence rate and CNV area in adhesive group was significantly less than that in control group （ P 〈 0. 05 ）. Conclusion α-alkyl cyanoacrylate play a role
出处
《眼科研究》
CSCD
北大核心
2009年第10期906-910,共5页
Chinese Ophthalmic Research
基金
全军医药卫生科研基金项目资助(06Z017)
关键词
激光共焦显微镜
Α-氰基丙烯酸酯
医用胶
角膜穿孔伤
laser confocal microscope
α-alkyl cyanoacrylate
medical adhesive
corneal perforation
