中国神经再生研究(英文版) ›› 2021, Vol. 16 ›› Issue (11): 2177-2183.doi: 10.4103/1673-5374.308666

• 综述:视神经损伤修复保护与再生 • 上一篇    下一篇

激光屈光手术后角膜神经介质概况

  

  • 出版日期:2021-11-15 发布日期:2021-04-13

Corneal neuromediator profiles following laser refractive surgery

Lily Wei Yun Yang, Jodhbir S. Mehta, Yu-Chi Liu   

  1. 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 2Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore; 3Department of Cornea and External Eye Disease, Singapore National Eye Centre, Singapore; 4Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
  • Online:2021-11-15 Published:2021-04-13
  • Contact: Yu-Chi Liu, MD, liuchiy@gmail.com.

摘要:

Neural Regen Res: 神经介质是激光屈光手术后眼表健康的潜在生物标志物

激光屈光手术是世界上最常用的手术之一。自从激光屈光手术引入眼科以来,屈光手术的数量迅速增加,全球屈光手术已超过1600万例。激光屈光手术后,角膜神经、上皮细胞和基质细胞释放神经介质,包括神经营养素、神经肽和神经递质。神经生长因子、P物质、降钙素基因相关肽和多种细胞因子是神经源性炎症和角膜神经再生的重要介质。神经介质不仅在生理稳态过程中起着重要作用,而且在损伤性刺激后的角膜伤口愈合中也起着重要作用。神经介质的释放是屈光手术后角膜神经再生和神经功能恢复的关键。特定神经介质的存在和水平已被证明影响激光屈光手术后不良反应的发生,如术后干眼症。

来自新加坡眼科研究所的Yu-Chi Liu认为神经介质代表角膜神经、上皮细胞、基质细胞和内皮细胞之间复杂的相互作用,它们相互释放的神经营养素、神经肽和神经递质对角膜内环境的稳定至关重要。激光屈光手术后神经介质的变化与手术技术和角膜组织损伤的严重程度密切相关。随着对神经介质的认识不断加深,以及角膜神经评估的进展,泪液神经介质作为激光屈光手术后眼表健康和角膜神经状态的潜在生物标志物受到了启发。未来的研究方向包括验证神经介质作为潜在的生物标志物,探索神经介质作为辅助物来帮助激光屈光手术后的角膜再生,或其他眼表疾病,如神经营养性角膜病和干眼症。

文章在《中国神经再生研究(英文版)》杂志20211111 期发表。

https://orcid.org/0000-0001-5408-0382 (Yu-Chi Liu) 

Abstract: Laser refractive surgery is one of the most commonly performed procedures worldwide. In laser refractive surgery, Femtosecond Laser in Situ Keratomileusis and Refractive Lenticule Extraction have emerged as promising alternatives to microkeratome Laser in Situ Keratomileusis and Photorefractive Keratectomy. Following laser refractive surgery, the corneal nerves, epithelial and stromal cells release neuromediators, including neurotrophins, neuropeptides and neurotransmitters. Notably, nerve growth factor, substance P, calcitonin gene-related peptide and various cytokines are important mediators of neurogenic inflammation and corneal nerve regeneration. Alterations in neuromediator profiles and ocular surface parameters following laser refractive surgery are attributed to the surgical techniques and the severity of tissue insult induced. In this review, we will discuss the (1) Functions of neuromediators and their physiological and clinical significance; (2) Changes in the neuromediators following various laser refractive surgeries; (3) Correlation between neuromediators, ocular surface health and corneal nerve status; and (4) Future directions, including the use of neuromediators as potential biomarkers for ocular surface health following laser refractive surgery, and as adjuncts to aid in corneal regeneration after laser refractive surgery.

Key words: cornea, corneal nerves, dry eye, femtosecond laser, laser in situ keratomileusis, neuromediator, refractive surgery, small incision lenticule extraction