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了解不同位置、不同深度角膜损伤后 ,角膜神经恢复的特点和过程。方法 :以显微板层角膜移植术和显微板层角膜层间置换术为模型 ,通过光学显微镜、透射电子显微镜和扫描电子显微镜观察了术后 3周～ 8个月角膜神经恢复情况。结果 :显微板层角膜移植术后 2个月创缘神经以再生成环或以芽生的方式进入植片 ,术后 3个月可见粗大神经从周边长入植片 ,术后 6个月上皮下丛形成 ,术后 8个月神经基本恢复。显微板层角膜层间置换术术后 3周切缘两侧的受体神经开始再生 ,术后 2个月再生神经长入植片 ,术后 3个月切缘附近的自体神经基本恢复 ,上皮下丛形成 ,术后 5个月有神经长入层间镜片 ,术后 8个月角膜植片中央出现神经末梢。结论 :角膜神经受伤后可以再生重建 ,上皮下丛、基质浅丛和角膜周丛是主要再生来源 ,神经再生程度和时间上的差异不但与角膜伤口的位置和深度有关 ,还与角膜是单纯切开还是植入供体植片及瘢痕组织厚度有关。不同个体间甚至同一个体不同部位存在着较大差异 ,原因不明
To understand the different locations, different depth of corneal injury, the corneal nerve recovery characteristics and process. Methods: The corneal nerve recovery after 3 weeks to 8 months was observed by optical microscope, transmission electron microscope and scanning electron microscope with microgranular keratoplasty and microkeratome as the model. Results: 2 days after the microkeratoplasty, the perineural nerve regenerated into a ring or budded into the graft. After 3 months of operation, the thick nerve grew into the graft from the periphery. After 6 months, Cong formation, 8 months after the basic recovery of nerves. At 3 weeks after operation, the recipient nerves on both sides of the cut edge began to regenerate. The regenerated nerve grew into the graft at 2 months after operation. The autonomic nerves around the cut edge at 3 months postoperatively recovered basically. Subcutaneous plexus formation, 5 months after the nerve grow into the interlayer lenses, 8 months after the central corneal graft nerve endings. Conclusion: The corneal nerve injury can be reconstructed after regeneration. The subepidermal plexus, superficial basal plexus and corneal plexus are the main sources of regeneration. The degree of neural regeneration and the time difference are not only related to the location and depth of the corneal wound, but also to the corneal incision Open or implanted donor grafts and scar tissue thickness. Different individuals and even different parts of the same body there is a big difference, for unknown reasons