目的探讨兔眼碱烧伤行羊膜移植术后在眼表大体结构、病理组织学和超微结构三个方面的转归状况。设计随机对照实验性研究。研究对象60只新西兰白兔(120眼),按照伤后不同时间手术随机分为5组,包括保存羊膜移植组(A1组、A2组)、新鲜羊膜移植组(B1组、B2组)和对照组。每组12只兔(24眼)。方法分别应用保存羊膜和新鲜羊膜,在兔眼碱烧伤后第1天和第15天行羊膜移植术,裂隙灯检查术后第1、3、7、10、15、30天时羊膜在位情况,术后第3、7、15、30天作病理学和透射电子显微镜检查。主要指标裂隙灯显微镜观察角膜透明度、新生血管及球结膜充血情况;病理学检查和透射电子显微镜观察羊膜移植术后羊膜的动态变化。结果羊膜移植术后第30天,羊膜移植组兔眼的新生血管程度减轻,角膜透明度有不同程度的恢复,与对照组差异有显著统计学意义(P<0.001),早期羊膜移植组(A2组、B2组)的疗效明显优于晚期移植组(A1组、B1组)(P<0.001)。新鲜羊膜移植组(B2组)疗效优于保存羊膜移植组(A2组)(P<0.05)。病理学结果:术后第30天,角膜各层结构恢复完整,可见少量嗜酸性粒细胞和少量残存的新生血管。透射电镜检查:新鲜羊膜组术后第15天,羊膜上皮完整,基底层变薄,羊膜和角膜组织间形成连接,羊膜基底层面与角膜表面融合。30天后,角膜表面可见一层羊膜上皮细胞,羊膜基底层消失。结论碱烧伤早期羊膜移植对抑制角膜新生血管形成、减轻炎症和恢复角膜透明度有较好的治疗效果,新鲜羊膜优于保存羊膜。 Objective To investigate the prognosis of amniotic membrane burns after amniotic membrane transplantation in three aspects: gross ocular surface structure, histopathology and ultrastructure. Design Randomized controlled experimental study. Sixty New Zealand white rabbits (120 eyes) were randomly divided into 5 groups according to the operation time after injury, including the amniotic membrane transplantation group (group A1 and group A2), the fresh amniotic membrane transplantation group (group B1 and group B2) and the control group. Twelve rabbits in each group (24 eyes). Methods Amniotic membrane preservation and fresh amniotic membrane were used respectively. Amniotic membrane transplantation was performed on the first day and the 15th day after alkali burn in rabbits. The amniotic membrane was examined on the 1st, 3rd, 7th, 10th, 15th and 30th days after the operation. Pathology and transmission electron microscopy were performed on days 3, 7, 15 and 30 after operation. The main indicators of slit lamp microscope corneal transparency, neovascularization and conjunctival hyperemia; pathological examination and transmission electron microscopy of amniotic membrane after amniotic membrane transplantation dynamic changes. Results At the 30th day after amniotic membrane transplantation, the degree of neovascularization of rabbit eyes in amniotic membrane transplantation group was relieved, and the degree of corneal transparency recovered to some extent (P <0.001). In early amniotic membrane transplantation group (A2 group , B2 group) was significantly better than the late transplantation group (A1 group, B1 group) (P <0.001). Fresh amniotic membrane transplantation group (B2 group) than the preservation of amniotic membrane transplantation group (A2 group) (P <0.05). Pathological results: 30 days after surgery, corneal structure of each layer recovered intact, showing a small amount of eosinophils and a small amount of residual neovascularization. Transmission electron microscopy: Fresh amniotic membrane group 15 days after surgery, amniotic epithelium integrity, basal layer thinning, amniotic membrane and corneal tissue to form connections, amniotic basement level and corneal surface fusion. After 30 days, a layer of amniotic epithelial cells can be seen on the corneal surface, and the amniotic basal layer disappears. Conclusion Amniotic membrane transplantation in the early stage of alkali burn has good therapeutic effects on inhibiting the formation of corneal neovascularization, reducing the inflammation and restoring the transparency of the cornea. The fresh amniotic membrane is better than the preserved amniotic membrane.