ABSTRACT
AIM: To evaluate the biomechanical stability of the corneal scar treating with riboflavin and ultraviolet A (UVA). METHODS: Totally 86 New Zeal rabbits were divided into control group (group A, n=8) and trauma groups [group B (n=27), group C (n=24) and group D (n=27)]. Then groups B, C and D were divided into three sub-groups according to the time points of sacrifice, i.e. groups Ba, Ca and Da (4wk, n=8); Bb, Cb and Db (6wk, n=8); Bc (n=11), Cc (n=8) and Dc (8wk, n=11). The right corneas of these 78 rabbits in the trauma groups were penetrated. Group B were only sutured. Group C were treated with corneal cross-linking (CXL) immediately after suturing. Group D were treated with CXL seven days after suturing. The corneal scar strips of 4.0×10.0 mm2 were cut and the stress and Young's modulus at 10% strain were evaluated. Samples from the three rabbits of group Bc and three of group Dc were used to measure the expression of alpha smooth muscle action (α-SMA). RESULTS: The mechanical strength of the corneal scar increased with time, and was strongest at 8wk after the injury. The ultimate stress of corneal scar (group D) were 2.17±0.52 MPa, 2.92±0.63 MPa, and 4.21±0.68 Mpa at 4wk, 6wk and 8wk, respectively; Young's modulus were 10.94±1.57 MPa, 11.16±2.50 MPa, and 13.36±2.10 Mpa, which were higher than that of other groups except for normal control. The expression of α-SMA in group B and group D were 0.28±0.11 and 0.65±0.20, respectively, and the difference was statistically significant (P=0.048). CONCLUSION: CXL with riboflavin/UVA at seven days after suturing improved the biomechanical properties of corneal scars most effectively in the present study.
ABSTRACT
Background Suture stitching is currently the standard treatment for corneal penetrating injuries.The shortcomings of suture stitching have led to the exploration of non-sutured surgical methods.Tissue adhesive is a promising non-suture replacement procedure.Objective This study was to observe the effect of fibrin glue on large irregular rabbit corneal penetrating injury.Methods Eighteen pure white healthy rabbits were randomly divided into suture group and adhesive group.A total length of 6-mm non-self-sealing corneal penetrating injury in nonpupillary-area of the right eye formed with a 15° corneal puncture knife was repaired with fibrin glue plus temporary suture and therapeutic corneal contact lens (9 eyes) or with 3 to 5 interrupted 10-0 nylon sutures (9 eyes) with the fellow eyes acted as the internal controls respectively.Operative time was compared between the two groups.Clinic observation was performed with slit lamp microscope.Animals were humanely sacrificed for histologic examination at week 1,3,and 8 to evaluate wound healing.Results The average operation time was (3.48±0.48) minutes in the adhesive group,which was significantly lower than that in the suture group ([7.77 ± 1.30] minutes) (t =9.28,P＜ 0.01).The postoperative slit lamp microscope observation indicated corneal wounds were quickly and regularly healed in the glued corneas compared with the stitched ones.The histologic examination revealed that glued corneas had regular healing,mild inflammation,and no corneal neovascularization,while sutured corneas showed irregular fibrin arrays,a large number of inflammatory cells and macrophages infiltration around the suture,heavy inflammatory response.Neovascularization was found at week 3 postoperatively.Conclusions Fibrin glue combined with temporary suture and therapeutic corneal contact lens is an effective treatment in sealing large irregular corneal wounds with considerable advantages over traditional sutures,ircluding simplified operative technique,short surgery time,less postoperative irritation,mild inflammation,more regular wound healing,short healing time,and no corneal neovascularization.
ABSTRACT
Objective To evaluate the clinical effects of emergency neoplasty on corneal penetrating injury. Methods A total of 102 cases of corneal penetrating injury were investigated.The patients underwent micro-trauma technique suture,optical iridectomy,extraction of anterior segment foreign bodies,nepheloid lens removal,and artificial lens implantation.The vision of pre-and post-surgery was compared and relationship between injury location and recovery was analyzed. Results The injury of cornea repaired completely 1 month after surgery.Cross infection was not found in the patients with one-year long follow-up(80% of all patients).The vision of all patients raised.The injury in center and nasal side affected vision significantly. Conclusion Timely surgery to corneal penetrating injury may be considered in order to improve the recovery of the traumatic eyes.
