Objective To investigate the feasibility of photochemical tissue bonding (PTB) technique in repairing limbal stem cell (LSC) deficiency and the effect on cornea wound healing. Methods LSCs were isolated from limbus of New Zealand rabbits by tissue block culture method, and then the LSCs of 2nd passage were cultured on de-epithelialized human amniotic membrane (HAM) for 3 weeks to prepare the HAM/LSC grafts. The LSC deficiency models of the left eyes were established by 0.5 mol/L NaOH in 24 New Zealand female rabbits, aged 3-4 months and weighing 1.5-2.0 kg. HAM/LSC grafts were used to repair the cornea wounds by sutures (suture group, n=12) or by PTB technique (PTB group, n=12). The gross was observed including the corneal transparency, erythema, and new blood vessel formation after surgery. At 3 and 28 days, the inflammatory cytokine of interleukin 1β (IL-1β), IL-6, and tumor necrosis factor α (TNF-α) were assayed by ELISA method; and the amount of new blood vessels were quantified by immunohistochemistry staining at 28 days. Results All animals survived to the end of the experiment. At 3 days, there was no obvious difference in the corneal transparency between 2 groups; at 28 days, the corneal transparency of PTB group was higher than that of suture group, and new blood vessels decreased. HE staining showed that mass inflammatory cells infiltrated between graft and cornea basal layer at 3 days, and no new blood vessel formed. inflammatory cells infiltration significantly decreased at 28 days in PTB group; the amount of new blood vessels was (2.0 ± 0.8)/ HP in PTB group and was (6.3 ± 1.3)/HP in suture group, showing significant difference (t=7.966, P=0.002). At 28 days, the concentrations of inflammatory cytokine of IL-1β, IL-6, and TNF-α in suture group were significantly higher than those in PTB group (P lt; 0.05); however, no significant differences were observed between 2 groups at 3 days (P gt; 0.05). Conclusion PTB technique can be used to fix HAM/LSC grafts, which can decrease inflammatory cell infiltration and new vessel formation, and improve the outcomes when compared with suture technique.
目的 观察两种手术方式治疗翼状胬肉的临床效果。 方法 对2007年1月－2012年6月一般情况较好的73例单纯原发性双眼翼状胬肉患者进行了回顾性研究，比较同一患者双眼分别行翼状胬肉切除+生物羊膜移植（左眼）和翼状胬肉切除+自体角膜缘干细胞移植（右眼）手术后痊愈率、复发率及并发症。 结果 行翼状胬肉切除+自体角膜缘干细胞移植（右眼）的痊愈率达93.15%，复发率1.37%，并发症率5.48%，其痊愈率更高而复发率及并发症均更低。 结论 翼状胬肉切除+自体角膜缘干细胞移植用于治疗翼状胬肉比翼状胬肉切除+人工羊膜移植的疗效更好，值得临床推广。