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目的比较羊膜移植(amniotic membrane transplantation,AMT)、自体结膜移植(autologous conjunctivaltransplantation,ACF)、自体Tenon’s膜移植(autologous Tenon’s fasia transplantation,ATFT)在结膜重建中的作用。方法新西兰大白兔24只随机分组:对照8眼不作任何处理,滴bFGF眼药水8眼;AMT组16眼,ACT组8眼,ATFT组8眼。于第2,3,4,6周时杀死兔各2只,HE及透射电镜观察。结果 AMT组3w时结膜上皮移行至羊膜表面,6w时再生上皮的超微结构接近正常,但杯状细胞较正常少。ACT组从一开始就保持了上皮的完整性且杯状细胞丰富。ATFT组上皮再生与AMT组接近但有轻度结膜下纤维化。结论 AMT可有效地修复结膜表面,抑制炎症和瘢痕化。ATFT可改善眼表的基质和血供。ACT是修复结膜缺损的最有效方法。
Objective To compare the roles of amniotic membrane transplantation (AMT), autologous conjunctival transplantation (ACF) and autologous Tenon’s fasia transplantation (ATFT) in conjunctival reconstruction. Methods Twenty-four New Zealand white rabbits were randomly divided into control group (n = 8), untreated control group (n = 8) and bFGF eye drops (8 eyes). AMT group (n = 16), ACT group (n = 8) and ATFT group (n = 8) At the 2nd, 3rd, 4th and 6th week, 2 rabbits were killed, HE and TEM were observed. Results In the AMT group, the conjunctival epithelium migrated to the amniotic membrane surface at 3 weeks. The ultrastructure of regenerated epithelium was nearly normal at 6 weeks, but goblet cells were less than normal. The ACT group maintained epithelial integrity from the outset and the goblet cells were abundant. ATFT group epithelial regeneration and AMT group close but mild sub-conjunctival fibrosis. Conclusion AMT can effectively repair the conjunctiva surface and inhibit inflammation and scarring. ATFT improves ocular surface and blood supply. ACT is the most effective method of repairing conjunctival defects.