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目的研究角巩膜缘功能衰竭症的发生与角膜缘干细胞分布及干细胞缺乏的相关性。方法对8例后巩膜袭伤眼球摘除标本和46例角巩膜功能衰竭症手术病例切除标本进行病理检查,在镜下观察正常角膜缘与角巩膜缘功能衰竭症角膜缘干细胞层数、分布及干细胞的移行情况。结果正常角膜缘干细胞是不对称性分布,上、下角膜缘干细胞数量大于鼻、颞侧角膜缘,角膜缘功能衰竭处表面上皮细胞层数减小,形态扁平,部份萎缩、严重者缺乏;角巩膜缘衰竭处组织和正常角膜缘的交界处上皮细胞排列层数逐渐移行减少,基底膜破坏,细胞排列不规则,缺乏基底的干细胞与短暂扩充细胞。结论角膜缘干细胞不对称性分布、缺乏和破坏是发生角巩膜缘功能衰竭的重要因素。
Objective To investigate the relationship between limbal corneal margin failure and the distribution of limbal stem cells and stem cell deficiency. Methods Eight cases of posterior scleral injury enucleated and 46 cases of corneal scleral failure were selected for pathological examination. The number and distribution of limbal stem cells in normal limbus and corneal limbal failure were observed under microscope The migration situation. Results The normal limbal stem cells were distributed asymmetrically. The number of limbal stem cells in the upper and lower limbus was larger than that in the nasal and temporal limbal limbus. The number of epithelial cells in the limbal corneal limbal epithelium was decreased, the morphology was flat and partly atrophied, while the severe ones were scarce. Corneal limbal failure at the junction of the junctional tissue and normal limbal epithelial cells gradually reduce the number of layers, basement membrane destruction, irregular arrangement of cells, the lack of basal stem cells and transient expansion of cells. Conclusion The asymmetry distribution, deficiency and destruction of limbal stem cells are important factors for the occurrence of limbal scleral failure.