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目的 探讨硅胶对实验性角膜碱烧伤早期的治疗作用及疗效机制。方法 新西兰兔23只,单眼角膜中度碱烧伤,选择结膜囊内硅胶粉填充法(A组)和眼表局部硅胶粉隔吸法(B组)。C组为对照组,角膜碱烧伤后仅予生理盐水冲洗。第3,5周末摘取角膜行病理检查,烧伤后第7天摘取角膜行扫描电镜检查。结果A组于第2周角膜溃疡形成,第2周末溃疡穿孔;B组无1例形成溃疡,第7周角膜透明或半透明。对照组多形核白细胞(PMN)大量浸润,角膜细胞显著增多,胶原纤维杂乱排列,新生血管丰富。B组PMN浸润明显减少,胶原排列轻度紊乱,血管少而疏,瘢痕组织少。电镜下见A组角膜烧伤区表面及细胞间明显的硅胶颗粒残留,B组未见硅胶颗粒。结论 在角膜碱烧伤早期应用硅胶治疗可获良效,但应避免硅胶粉直接与眼表接触。
Objective To investigate the early therapeutic effect and mechanism of silica gel on experimental corneal alkali burn. Methods Twenty - three New Zealand rabbits were selected with moderate alkali burns in monocular cornea. Silicone powder was injected into conjunctival sac (group A) and silica gel powder inhalation (group B). Group C was the control group, which was rinsed with saline only after corneal alkali burn. At the end of the third and fifth weeks, cornea was taken for histopathological examination. On the seventh day after burn, the cornea was examined by scanning electron microscopy. Results In group A, corneal ulcer was formed in the second week and perforation was observed in the second week. In group B, no ulcer was found in one case and the cornea was transparent or semitransparent in the seventh week. The control group of polymorphonuclear leukocytes (PMN) infiltration, corneal cells increased significantly, collagen fibers arranged in disorder, rich in neovascularization. The infiltration of PMN in group B was significantly reduced, the collagen arrangement was slightly disturbed, blood vessels were less and sparse, and scar tissue was less. Electron microscopy, A group of corneal burns area and the obvious surface of the cell residual silica particles, B group did not see the silica gel particles. Conclusion The application of silica gel in the early stage of corneal alkali burn can be good, but should avoid direct contact with ocular surface.