本研究旨在评估富血小板血浆(PRP)的作用,自体血清(ABS),和脐带血清(UCS)对穿透性角膜移植术(PK)后角膜愈合的影响。总共120只新西兰白兔,四十人被指定为捐赠者,其余80只兔在接受PRP组(n=20)后随机分为4组,ABS组(n=20),UCS组(n=20)和对照组(n=20)。角膜混浊评分,角膜血管化,角膜染色,组织病理学分析,和免疫组织化学分析(包括CD4+,CD8+,和主要组织相容性复合物[MHC]II)在术后1、2、3和12周进行评估。结果表明,各组间角膜混浊评分和角膜血管形成无明显差异。然而,与其他组相比,PRP组的角膜染色在统计学上较高(0.40±0.60)(p=0.011)。免疫组织化学检查显示CD4+无显著差异,CD8+,和组之间的MHCII水平。值得注意的是,在所有群体中,CD4+,CD8+,和MHCII水平在12周时显著高于其他时间点。PRP,ABS,和UCS对PK后角膜愈合表现出积极作用。然而,在这三种产品中,PRP在PK程序后的术后阶段表现出优于ABS和UCS的治疗效果。因为它们显著影响视觉质量,移植物透明度,移植物存活,和预防感染引起的基质吸收。尽管角膜的无血管性质及其免疫特权,无法解决通常在PK后观察到的上皮缺损(ED)可导致不可逆的疤痕和溃疡,导致移植物排斥。虽然在术后第一天在14-100%的病例中观察到上皮缺损,在随后的时期中,约有3-7%的患者持续存在非治愈性ED。总之,我们的研究表明,PRP,ABS,和UCS对PK后角膜愈合有积极作用。
This study aimed to evaluate the effects of platelet-rich plasma (PRP), autologous blood serum (ABS), and umbilical cord serum (UCS) on corneal healing following penetrating keratoplasty (PK). A total of 120 New Zealand white rabbits, forty were designated as donors, while the remaining eighty rabbits were randomly divided into four groups after undergoing PRP Group (n = 20), ABS Group (n = 20), UCS Group (n = 20) and Control Group (n = 20). Corneal opacity score, corneal vascularization, corneal staining, histopathological analysis, and immunohistochemical analysis (including CD4+, CD8+, and major histocompatibility complex [MHC] II) were assessed at postoperative 1, 2, 3, and 12 weeks. The results showed that corneal opacity score and corneal vascularization did not differ significantly among the groups. However, corneal staining was found to be statistically higher in the PRP group (0.40 ± 0.60) compared to the other groups (p = 0.011). Immunohistochemical examination revealed no significant differences in CD4+, CD8+, and MHC II levels among the groups. Notably, in all groups, CD4+, CD8+, and MHC II levels were significantly higher at 12 weeks compared to other time points. PRP, ABS, and UCS demonstrated positive effects on corneal healing after PK. However, among the three products, PRP exhibited a superior healing effect compared to ABS and UCS crucial in the postoperative period following PK procedures, as they significantly impact visual quality, graft transparency, graft survival, and prevention of stromal resorption caused by infections. Despite the avascular nature of the cornea and its immune privilege, failure to resolve epithelial defects (ED) commonly observed after PK can result in irreversible scarring and ulceration, leading to graft rejection. While epithelial defects are observed in 14-100% of cases on the first postoperative day, approximately 3-7% of them persist as non-healing ED in subsequent periods. In conclusion, our study demonstrated that PRP, ABS, and UCS have a positive effect on corneal healing after PK.