目的 动态观察准分子激光屈光性角膜切削术（photorefractive keratectomy，PRK）后角膜组织细胞外基质（extracellular matrix，ECM）成分的变化，并探讨其与角膜雾状混浊(haze)的关系。方法 24只兔按术后即刻、24 h、1周、2周、1个月、3个月、6个月及12个月不同处死时间分为8个实验组，每组3只，按设计矫正度数-10.00 D行右眼PRK术，术后裂隙灯显微镜检查各组角膜的haze分级，并取角膜组织以免疫组织化学方法检测ECM成分，包括Ⅰ型胶原蛋白、Ⅲ型胶原蛋白、Ⅵ型胶原蛋白、细胞纤维连接蛋白（cellular fibronectin，cFN）、细胞黏合素（tenascin，TN）及层黏连蛋白（laminin，LN）。结果 PRK术后haze的发生率为100%；角膜基质浅层内沉积新合成的Ⅰ、Ⅲ、Ⅵ型胶原蛋白及cFN、TN、LN等ECM成分，其表达量变化与haze分级变化基本一致。结论 PRK术后切削区角膜基质浅层ECM成分的沉积与角膜haze的出现密切相关。%Objective To investigate the relationship between the haze formation and the change of extracellular matrix (ECM) in the corneal tissue after photorefractive keratectomy (PRK). Methods Twenty-four adult New Zealand White rabbits received PRK in the right eye for -10.00 D ablation. According to the time of rabbits sacrifice, they were divided into 8 groups, and 3 rabbits were in each group. They were immediate, 24 hour, 1 week, 2 week, 1 month, 3 month, 6 month and 12 month groups. After surgery, the corneas were examined periodically by slip-lamp microscopy for haze formation. The right eyes were enucleated, and the corneas were studied with immunohistochemical evaluation for extracellular matrix, including collagen type Ⅰ, type Ⅲ, type Ⅵ, cellular fibronectin, tenascin and laminin. Results The incidence of haze was 100% after PRK. The formation of haze had a tendency from mild to severe, and along with the time prolongation, it gradually decreased and disappeared. The newly synthesized collagen type Ⅰ, type Ⅲ, type Ⅵ, cellular fibronectin, tenascin and laminin were deposited in the anterior corneal stroma. Conclusion The formation of haze is closely related to the deposition of ECM elements in the anterior corneal stroma in the surgical area.
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