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目的探讨小切口深板层角膜内皮移植术后角膜伤口愈合的组织病理学特点。方法45只豚鼠分为受体组30只(30只眼)和供体组15只(30只眼),进行同种异体深板层角膜内皮移植。受体组豚鼠右眼为术眼,左眼的正常角膜作为组织病理学对照。于术后1、2周、1、2、3、4个月分别处死受体组2只角膜恢复透明的豚鼠,取左、右眼角膜组织经内皮细胞茜素红染色、苏木素．伊红和(或)高碘酸希夫染色后行光镜检查,计数角膜基质内细胞。结果受体组有22只眼术后角膜透明,角膜内皮细胞经茜素红染色后显示植片上内皮细胞形态和排列正常,在植床与植片间存在环形的内皮细胞异型区域。光镜检查显示,术后早期在角膜板层分离的径路上,基质内细胞明显增多;植床与植片的交接处,后板层胶原纤维和后弹力层中断,后者的残端卷起;交接处的空隙由结构紊乱、细胞成分较多的组织填充;而板层界面上胶原排列整齐。术后1个月时,出现新生的后弹力层。术后3～4个月时,后弹力层和后板层连续性恢复。结论小切口深板层角膜内皮移植术的基质创口愈合特点与损伤形式有关,板层界面上胶原排列整齐,纤维化的愈合方式见于植床与植片的连接处。
Objective To investigate the histopathological features of corneal wound healing after small incision deep lamellar keratoplasty. METHODS: Forty-five guinea pigs were divided into three groups: 30 recipients (30 eyes) and 15 donors (30 eyes). Allograft corneal endothelium transplantation was performed. The right eye of the recipient group was operated eye and the normal cornea of the left eye was used as a histopathological control. At 1, 2 weeks, 1, 2, 3 and 4 months after surgery, 2 corneas of the recipient group were sacrificed and guinea pigs were recovered. Left and right corneas were stained with alizarin red and stained with hematoxylin. Eosin and / or periodic acid Schiff staining after light microscopy, counting cells within the corneal stroma. Results The cornea was transparent in 22 eyes of the recipient group. The corneal endothelial cells were stained with alizarin red and the morphology and arrangement of the endothelial cells were normal. There was a ring - shaped endothelial cell dysplasia between the graft and the graft. Light microscopy showed that in the early postoperative path of corneal lamellar separation, the stromal cells increased significantly; graft and graft junction, the back plate of collagen fibers and the elastic layer of the back, the latter stump rolled up ; The junction of the gap by the structural disorder, cell components more tissue filled; and the interface layer of collagen arranged in neat rows. One month after the operation, a newborn post-elastic layer appeared. After 3 to 4 months, the continuity of the posterior elastic layer and posterior lamella recovered. Conclusion The characteristics of matrix wound healing in small incision deep lamellar corneal endothelium transplantation are related to the injury form. The collagen in the lamellar interface is arranged neatly. The healing way of fibrosis is found in the junction of the implantation bed and the implants.