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The Pathohistology Changes of the Autogenous Vein Graft after Reconstructing Lacrimal Cancanaliculus in Rabbits

Author: HuXinMiao
Tutor: ZhuYu
School: Zhengzhou University
Course: Ophthalmology
Keywords: Rabbit Canalicular defect Autogenous vein graft Alterations
CLC: R779.6
Type: Master's thesis
Year: 2009
Downloads: 7
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Abstract

Background and Purpose canalicular superficial location, the inside of the eyelid trauma can easily lead to the canalicular injury the inferior lacrimal duct injury is more common in the clinical, severe trauma is a common cause of the canalicular full injury, a surgery can not be lacrimal pass more extension fix the problem, the low success rate, can easily lead to patients with life-long tears, affecting its vision and life. Currently, the standard method for the treatment of the canalicular full injury conjunctival lacrimal sac anastomosis and tears moral tube implantation. But the conjunctiva dacryocyst anastomosis change the the lacrimal sac physiological position, easy to make the lacrimal sac muscle damage, loss of normal siphon effect, although postoperative lacrimal duct patency, epiphora persists; tear moral tube implantation easy because of righteousness The tube shift or granulation tissue formation can not achieve the desired results. Use to maintain autologous vein graft reconstruction canalicular lacrimal duct the original physiological structure and function, and easily obtained, and economically viable. From the sixties of the last century, started to clinical reports using autogenous vein graft to repair the tear duct, but no experimental study of the system. This study used in the case of surviving in the the canalicular full damage lacrimal sac, the the autologous vein conjunctival sac - the lacrimal sac transplant reconstruction canalicular observed vein graft survival of or alterations to provide experimental data for clinical application. Materials and methods Animal grouping healthy adult Japanese white rabbits 39, weighing 2.0-2.5kg, of either sex, no eye disorders and head and face abnormalities. 3 were randomly selected as normal control group (6), and the remaining 36 rabbits (72) were randomly divided into left and right eye the conjunctiva - dacryocyst group and Tears Lake - dacryocyst group (n = 36) The observed time points after six standard two experimental groups were divided into six groups, each group of 12. 2 surgical methods rabbit anesthesia whichever is the marginal ear vein cut 8-10mm sets of trimming on standby for lacrimal special silicone tube, into the road cut by the tears of the lacrimal sac a scleral puncture knife in the conjunctiva or tears Lake to do a channel lacrimal sac, and blood vessels at both ends, respectively, consistent with the the conjunctiva / Tears Lake and tears wall will remove the ear vein placement channel the conjunctiva end silicone tube fixed on the eyelid, lacrimal sac end silicone tube is inserted into the nasolacrimal duct, incision suture lacrimal sac. The normal control group without surgical treatment. 3 project and the time of observation points 1,3,5,7,14,28 days after the observed experimental group lacrimal duct patency; eye surgery generally; of transplant vascular pathology and morphological characteristics; clear immunohistochemical staining stratified count on the cortex and the epithelial lower cell proliferation. Normal control group the observation projects Ibid, the data used as normal controls. 4 Statistical analysis Statistical analysis was performed using SPSS11.0 software. The measurement data are used (?) ± s said, the conjunctiva - dacryocyst group and tears the lake - dacryocyst group PCNA - positive cell index compared using paired t test; conjunctiva - dacryocyst group, tears the lake - dacryocyst group respectively with normal control group, PCNA-positive cells Index independent samples t-test was used to compare; the conjunctiva - lacrimal sac group, the tears the lake - dacryocyst group, normal control group fluorescein excretion tests positive compared using one-way ANOVA. Α = 0.05 as the level of inspection. 1 conjunctival sac - lacrimal sac vein graft reconstruction tears Tears Lake - small tubes postoperative patency of the lacrimal lacrimal sac group at 14 days after surgery, conjunctiva - dacryocyst group at 28 days after surgery, lacrimal fully restored guide tears functionality. 28 days after the conjunctiva - dacryocyst group fluorescein excretion test positive time with tears lake - dacryocyst group and normal control group showed no significant difference (P> 0.05). 2 after transplantation, eye surgery generally one day after surgery, and conjunctiva severe congestion and edema, accompanied by a large number of secretions, epiphora obvious; 3 days after surgery, conjunctival edema improved slightly, secretions significantly reduced epiphora mitigate; postoperative days, conjunctival edema subsided basic secretions confined to the silicone tube Week epiphora improved markedly; 7 days after the silicone tube only weeks conjunctiva, conjunctival hyperemia, edema has subsided, some rabbit mild epiphora; 14 days after surgery the silicone tube weeks mild conjunctival hyperemia, the appearance no obvious abnormalities; 28 days after the appearance, as the less than abnormal performance. The conjunctiva - dacryocyst group and tears the lake - dacryocyst group show no difference. 3 vein graft pathology and morphology 3.1 The general concept of one day after three days, the vein graft severe hyperemia high degree of edema, seen a lot of secretions in the lumen; five days after surgery, congestive edema compared with the previous improved markedly reduced exudate; 7 days after the operation, the basic congestion and edema subsided, exudate and necrotic tissue, as the less than smooth inner walls of blood vessels, and surrounding tissue boundaries is not obvious; 14 days after surgery, vein graft and the surrounding tissue is basically the same color, illegible to the naked eye, their boundaries ; 28 days after surgery, the only judge by suture vein graft and surrounding tissue boundaries. Two experimental group showed no significant difference. 3.2 HE staining results after one day, three days vein graft endothelial cells began to fall, necrosis, endothelial smooth muscle cell degeneration; five days after surgery, collapsed a large number of smooth muscle cells, fibroblasts, there was a large red dye homogeneous regional structure; 7 days after the proximity of the vein graft anastomosis visible anastomosis epithelial migration to the vascular subepithelial fibroblasts significantly; 14 days after surgery, vein graft both ends of adjacent tissue epithelial lining and newborn middle of the transitional epithelium to vascular the subepithelial fibroblast proliferation active; 28 days after surgery, vein graft cortex most new epithelial covering, the subepithelial visible collagen fibers parallel or staggered distribution, which fibroblast distributed. Pathology performance of the two experimental groups are basically the same. Transplant vascular cell proliferation observed (the PCNA immunohistochemistry chemical staining results) after three days, the transplant vascular positive cells located mainly on the skin, only a very small number of positive cells within the epithelium; PCNA-positive cells of mesothelial cells after 7 heaven The index increased significantly, epithelial cells and fibroblasts PCNA-positive cells Index peaked; 7 days after the epithelial cells and fibroblasts PCNA-positive cells Index decreased. Postoperative observation time point the conjunctiva - dacryocyst group and tears Lake - the lacrimal sac group epithelial cells and fibroblasts PNCA-positive cells Index no significant difference (P> 0.05); postoperative 28 days the conjunctiva - dacryocyst group with Tears Lake - the epithelial cells of the lacrimal sac group and fibroblast PCNA-positive cells index were higher than the normal control group (P <0.05). Conclusion 1. Rabbits 8-10mm long since venous conjunctival sac - the lacrimal sac graft tears tubule transplant vascular alterations to the formation of the lumen of the membrane. The 2. Rabbits 8-10mm long autologous vein conjunctival sac the - the lacrimal sac graft canalicular Tears the lake - dacryocyst group 14 days 28 days, conjunctiva - dacryocyst group can fully restore the guide tears functionality. Rabbit 8-10mm long autologous vein conjunctival sac - the reconstruction of the lacrimal sac transplant lacrimal tube after conjunctival sac and lacrimal sac epithelium transitional form a new canalicular epithelium, epithelial covering not yet been completed for 28 days; myometrial degeneration degradation of the vessel wall remodeling, 28 The day is still in the proliferative phase.

The Pathohistology Changes of the Autogenous Vein Graft after Reconstructing Lacrimal Cancanaliculus in Rabbits

Abstract

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