각막 기질창상에서 양막이 각막상피두께와 반결합체의 형성에 미치는 영향
Effect of Amniotic Membrane on Epithelial Thickness and Formation of Hemidesmosomes after Corneal Stromal Wound
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목적: 각막 기질창상 치유에서 양막이 각막상피두께와 반결합체의 형성에 미치는 영향에 대해 연구해 보고자 하였다. 대상과 방법: 미세각막 절삭기를 이용해 토끼의 각막에 직경 9 mm, 두께 130 μm의 각막 기질창상을 만든 후 양막반을 덮은 군, 치료용 콘택트렌즈를 사용한 군과, 치료를 하지 않은 대조군으로 나누어 각막 상피두께의 변화와 반결합체 형성을 비교하였다. 2주와 4주 후 H&E 염색을 하여 각막 상피두께를 관찰하였고, 전자현미경으로 반결합체의 형성을 관찰하였다. 결과: 창상치유 2주째 양막군의 각막 상피두께는 95.3 ± 6.3 μm로 76.4 ± 5.1 μm와 68.3 ± 6.1 μm인 콘택트렌즈군과 대조군과 비교 해 유의하게 두꺼웠다. 또한 반결합체 형성에서도 양막군은 다른 두 군과 비교해 보다 많은 반결합체를 형성하였다. 그러나 창상치유 4주째에는 세 군 간에 각막상피두께와 반결합체 형성에 차이가 없었다. 결론: 창상치유 2주째 양막군이 콘택트렌즈군과 대조군에 비해 각막상피 두께가 두꺼웠으며 더 많은 반결합체를 형성하였다. 따라서 각막 기질창상의 초기 치유에 양막반을 사용하는 것은 효과적인 치료법이라 생각한다.
Abstract
Purpose: To investigate the effects of an amniotic membrane patch on corneal epithelial thickness and formation of hemidesmosomes during corneal stromal wound healing. Methods: A stromal wound 9 mm in diameter and 130 μm in depth was created on rabbit cornea using a microkeratome. The changes in corneal epithelial thickness and hemidesmosome formations were compared between the amniotic membrane, contact lens, and control groups. Changes in the corneal epithelium were examined using H&E staining and hemidesmosome formation was examined using an electron microscope at 2 and 4 weeks after flap removal. Results: Two weeks after treatment, the corneal epithelial thickness was 95.3 ± 6.3 μm in the amniotic membrane group being significantly thicker than 76.4 ± 5.1 μm in the contact lens group and 68.3 ± 6.1 μm in the control group. Furthermore, more hemidesmosome formations were observed in the amniotic membrane group compared to the other 2 groups. However, there were no significant differences in corneal epithelial thickness or hemidesmosome formation among the 3 groups at week 4. Conclusions: The amniotic membrane group showed a thicker corneal epithelium and more hemidesmosome formation than the other 2 groups 2 weeks after flap removal. Thus, the use of an amniotic membrane patch appears to be effective in the early stages of corneal stromal wound healing.
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