Objective To review research progress of corneal tissueengineering.Methods The recent articles on corneal tissue engineering focus on source and selection of corneal cells, the effects of growth factors on culture of corneal cells in vitro. The preparation and selection of three-dimensional biomaterial scaffolds and their b and weak points were discussed. Results The corneal tissue engineering cells come from normal human corneal cells. The embryo corneal cell was excellent. Several kinds of growth factors play important roles in culture, growth and proliferation of corneal cell, and incroporated into matrix.Growth factors including basic fibroblast growth factor, keratinocyte growth factor, transforming growth factor β1 and epidermal growth factor was favor to corneal cell. Collagen, chitosan and glycosaninoglycans were chosen as biomaterial scaffolds. Conclusion Human tissue engineering cornea can be reconstructed and transplanted. It has good tissue compatibility and can be used as human corneal equivalents.
Objective To evaluate the effects of surgical treatment for severe ocular rupture with blood staining of cornea and non-light perception , and analyze the relative factors. Methods Seven severely rup tured eyes of 7 patients with blood staining of cornea and non-light perception underwent second-stage penetrating keratoplasty combined with vitrectomy using temporary keratoprosthesis. All injured eyes had blood staining of cornea, hemorrhage in anterior chamber and vitreous, and choroidal and retinal detachment before the second-stage surgery. The average interval of the two surgical stages was 18 days (12-21 days). The preoperative visual acuity was non-light percept ion in all injured eyes with the mean intraocular pressure of 3 mm Hg (1 mm Hg =0.133 kPa) (2-5 mm Hg).The mean follow-up period was 12 months (6-30 months). Results The postoperative visual acuity was better than light perception in 5 eyes with the best corrected visual acuity of light perception to 0.06. The retina was attached in 5 eyes (5/7). The mean postoperative intraocular pressure was 12 mm Hg(5-15 mm Hg)which was significantly higher than the preoperative one (Plt;0.05). Postoperative complications mainly included temporary intraocular hypertension (1 eye), corneal neovasculariza tion (4 eyes), cornea rejection (4 eyes), and ocular atrophy (2 eyes). Conclusion Penetrating keratoplasty combined with vitrectomy using temporary keratoprosthesis is a safe and effective method in treating severe ocular rupture with blood staining of cornea and non-light perception. (Chin J Ocul Fundus Dis，2004，20：212-214)
Due to lack of the practical technique to measure the biomechanical properties of the ocular cornea in vivo, clinical ophthalmologists have some difficulties in understanding the deformation mechanism of the cornea under the action of physiological intraocular pressures. Using Young's theory analysis of the corneal deformation during applanation tonometry, the relation between the elasticity moduli of the cornea and the applanated corneal area and the measured and true intraocular pressures can be obtained. A new applanation technique has been developed for measuring the biomechanical properties of the ocular cornea tissue in vivo, which can simultaneously acquire the data of the applanation area and displacement of the corneal deformation as well as the exerted applanation force on the cornea. Experimental results on a rabbit's eyeball demonstrated that the present technique could be used to measure the elasticity moduli and creep properties of the ocular cornea nondestructively in vivo.
【摘要】目的评价双氯芬酸钠滴眼液在准分子激光上皮下角膜磨镶术(LASEK)中的临床应用价值。方法2008年7月2009年3月行LASEK术患者80例160眼,屈光度范围-4.86D±2.15D(-1.25D～-6.50D),随机分为双氯芬酸钠滴眼液组(试验组)和对照组,对两组术后角膜刺激症状、上皮愈合情况进行对比观察和统计学分析。结果试验组术后第1、3天角膜刺激症状明显轻于对照组(P＜0.05),上皮愈合速度较对照组更快(P＜0.05)。结论在LASEK术中合理使用双氯芬酸钠滴眼液,可明显减轻术后患者角膜刺激症状,促进角膜上皮的更快愈合。
目的:探讨高龄白内障患者术前角膜内皮功能状态。方法:对从2007年11月到2008年10月的66例年龄在80岁或以上的左眼白内障患者术前角膜内皮细胞形态及中央角膜厚度进行回顾性分析。分析参数包括角膜内皮细胞密度,内皮细胞平均面积,最大细胞面积和最小细胞面积,内皮细胞变异系数,面积标准差,六角形细胞比例及角膜中央厚度。结果:患者的角膜内皮细胞平均密度为(2720.3±324.6)个/mm2,平均细胞面积为(375.4±70.3)μm2,最大细胞面积(922.1±243.5)μm2,最小细胞面积(131.2±40.2)μm2,面积标准差(143.5±34.8)μm2,细胞变异系数(38.0±7.3)%,六角形细胞比例(52.8±10.1)%。中央角膜厚度与角膜内皮细胞密度之间无相关性。结论:高龄人白内障患者的角膜内皮细胞密度高,角膜功能基本正常，是保持角膜透明的基础,为眼内手术或治疗提供安全保障。
Objective To observe the biocompatibility of the acellular corneal stroma materials prepared by three different methods. Methods Three different serial digestion methods were used to produce the acellular corneal stroma materials. The biocompatibility of the materials was investigated by the cell seeding and the materials were implanted into the rabbit corneal stroma layer. Results The cells in the materials 1 and 2 were not decellularized completely. The rabbit corneal fibroblasts died on the materials 1 and 2 after the cell seeding for 3-4 days. An obvious rejection could be observed after the implantation. The cells in material 3 were decellularized completely and the collagen fibers or elastic fibers were reserved integrally，showing a typical three-dimensional net work. The rabbit corneal fibroblasts could expand on the materials in vitro. No obvious rejection could be observed and the materials were gradually absorbed. Conclusion The acellular porcine cornea stroma materials prepared by trypsin-Dnase-Rnase are suitable for reconstruction of the tissue engineered cornea.
Objective To evaluate glaucoma and anterior chamber angle changes after intravitreal silicone oil injection(SOI). Methods The intraocular pressure(IOP) and anterior chamber angles of 34 e yes(33 patients)undergone pars plana vitrectomy and SOI were observed. Results Glaucoma occurred in 9 eyes(26%),in which silicone oil glaucoma(SOG) accounted for 77%(7/9).The changes of the superior part of anterior chamber angle were peripheral anterior synechiae in 11 eye(32%) and SO emulsification droplets in 22 eyes(64%) in 1～4.5 months after surgeries.Glaucoma occurred in 6 eyes of 7 eyes undergone peripheral iridectomy at the inferio r part of the iris after the closure of iridectomy holes (plt;0.05). Conclusion High incidence of glaucoma was found in this series of patients after intravitreal silicone oil injection,and the main causes of SOG were closure of the inferior iridecomy hole and silicone emulsification. (Chin J Ocul Fundus Dis, 2001,17:105-107)
We conducted this study to explore the influence of the ocular residual aberrations changes on contrast sensitivity (CS) function in eyes undergoing orthokeratology using adaptive optics technique. Nineteen subjects' nineteen eyes were included in this study. The subjects were between 12 and 20 years (14.27±2.23 years) of age. An adaptive optics (AO) system was adopted to measure and compensate the residual aberrations through a 4-mm artificial pupil, and at the same time the contrast sensitivities were measured at five spatial frequencies (2,4,8,16, and 32 cycles per degree).The CS measurements with and without AO correction were completed. The sequence of the measurements with and without AO correction was randomly arranged without informing the observers. A two-interval forced-choice procedure was used for the CS measurements. The paired t-test was used to compare the contrast sensitivity with and without AO correction at each spatial frequency. The results revealed that the AO system decreased the mean total root mean square (RMS) from 0.356 μm to 0.160 μm(t=10.517, P＜0.001), and the mean total higher-order RMS from 0.246 μm to 0.095 μm(t=10.113, P＜0.001). The difference in log contrast sensitivity with and without AO correction was significant only at 8 cpd (t=-2.51, P=0.02). Thereby we concluded that correcting the ocular residual aberrations using adaptive optics technique could improve the contrast sensitivity function at intermediate spatial frequency in patients undergoing orthokeratology.
目的 探讨聚乙二醇滴眼液对准分子激光上皮下角膜磨镶术（LASEK）后角膜雾状混浊（haze）影响的临床研究。 方法 回顾性分析2009年3月－2010年3月行LASEK的患者45例90只眼的临床资料。患者屈光度（?4.68 ± 2.30）D（?1.75～?6.50 D），随机分为聚乙二醇滴眼液组（试验组）和对照组，术后定期随访观察两组角膜haze形成、角膜上皮愈合时间、视力恢复情况及屈光度。 结果 术后1、3、6个月，两组haze形成差异无统计学意义（P＞0.05），试验组术后第1、3、5天角膜刺激症状明显轻于对照组（P＜0.05），上皮愈合速度较对照组更快（P＜0.05）。 结论 LASEK术后应用聚乙二醇滴眼液虽然能减轻术后患者角膜刺激症状,能促进角膜上皮更快愈合，但是不能减轻haze的形成。