摘要目的 探讨一种新型的免缝合光化学组织粘合术(photochemical tissue bonding,PTB)修复角膜穿透伤的方法,并评价其疗效. 方法 60只新西兰大白兔建角膜穿透伤模型,伤后左眼用缝合法修复损伤,右眼以PTB技术固定羊膜封闭创面,伤后不同时相点观察眼前房液渗漏清况及前房形态；评价眼内压情况；取角膜组织行组织学检测,观察角膜的新生血管和瘢痕形成,比较两种方法的修复效果. 结果 两组均未见眼房水渗漏,且眼前房深浅均正常无差别；PTB组见羊膜与角膜贴合紧密.PTB治疗后0,1,7d最大眼内压分别为(531.2±49.5) mm Hg、(542.6±74.8) mm Hg、(603.9±69.1) mm Hg,明显优于缝合组[(41.3±12.7) mmHg、(142.6±25.4) mm Hg、(333.3 ±66.7) mm Hg](P＜0.01).PTB组角膜新生血管和肉芽形成在伤后14,28及90 d时明显少于缝合组. 结论 PTB结合羊膜是一种即时、有效封闭角膜穿透伤的方法,且修复效果明显优于缝合法.

abstractsObjective To develop a new sutureless technique (photochemical tissue bonding,PTB ) for repair of corneal perforation. Methods A total of 60 rabbits were used for creating corneal perforation models.The corneal perforation on the left eye was repaired by sutures and the injury on the right eye was fixed with the use of amniotic membrane with PTB.The outcomes of the two mentioned repair methods were compared by observing the leakage of aqueous and the morphology of the anterior chamber at different instants,measuring the intraocular pressure (IOP) and observing the formation of neo-vessels and scars of cornea in the use of histological analysis. Results There was no leakage of aqueous and no difference for morphology evaluation in both treatments.PTB could adhere AM on the cornea to restore the corneal perforation.The peak IOP in the PTB treatment group at days 0,7 and 14 postoperative [ (531.2 ±49.5) mm Hg,(542.6 ±74.8) mm Hg and (603.9 ±69.1) mm Hg,respectively] was significantly higher than that in the suture group at the same instants [ (41.3 ±12.7) mm Hg,(142.6 ±25.4) mm Hg and (333.3 ± 66.7) mm Hg,respectively] (P ＜0.O1 ).Compared with suture repair,the treatment with PTB resulted in a better outcome of wound healing with less neo-vessels and less scars of cornea. Conclusion PTB treatment for repair of corneal perforation is superior to suture repair.