| Objective: Using ELISA kit to detection the content of NGF in the tear fluid, and applying with corneal confocal microscopy to observe patients’ corneal subepithelial nerve repair after corneal transplantation, we analysis the relationship of nerve regeneration and change in NGF content in the tear fluid of patients after keratoplasty.Materials and methods: Follow up case study. In this study, we collected the patients who received corneal transplantation for the first time in the Ophthalmology Department in the first affiliated Hospital of Jilin University from May 2015 to December 2015, and the clinical data collected from patients who were followed up for more than 3 months. Tear fluid were collected to detect the content of NGF during the follow up period, 1 day before surgery, 1 day, 7 days, 1 month and 3 months after surgery, respectively, In 1 month and 3 months after keratoplasty, we use corneal confocal microscopy to record corneal subepithelial nerve repair,we observed the growth of small nerve bud on the edge of corneal transplant graft. The data were analyzed by SPSS 23.0. The compare of NGF levels in tear fluid preoperative and postoperative were using pair-wise t test, P<0.05 has significant difference;analysis according to age, infection, operation and other factors were using multi factor univariate analysis of variance, P<0.05 has statistical significance; compare of NGF levels and subepithelial nerve regeneration were using non-parametric test, P<0.05 has statistical significance.Results: According to the inclued criteria,28 patients(30 eyes) were selected,among them, 19 cases were PKP(63.3%), DLKP 11 cases(36.7%); infection eyes were 19 cases(63.3%) and non-infection eyes 11 cases(36.7%); 18 patients were older or equal to 40 years(60.0%), and 12 patients were younger than 40 years(40.0%). Statistical results showed that the content of NGF in tear fluid in 1 day post-operation was lower than 1 day pre-operation,however, 7 day, 1 month and 3 months post-operation were higher than per-operation(P< 0.05) these informations were statistically significant;the change of tear NGF content according to the operation method were statistical significance in 1 month(P< 0.05),however,the other time points have no statistical significance(P>0.05);according to the infection factor, each follow-up time point have no statistical significance(P>0.05); similarly,according to age factor,each follow-up time point have no statistical significance(P>0.05). 17 eyes were unable to abserved nerve repair in 1 month post-operation(56.7%), 13 eyes were abserved small neural buds growth from transplantation disc surrounding(43.3%);besides,6 eyes were unable to abserved nerve repair in 3 months postoperative(20.0%), 24 eyes were abserved a small neural bud growth from transplantation disc surrounding(80.0%). Statistics analysis showed that with the increasing of the content of NGF in tear fluid, the number of cases who can observed small nerve bud growth were increasing and there is statistical significance(P< 0.05).Conclusion: The tendency of NGF content in the tear fluid of patients after keratoplasty decreased firstly, than gradually increased, related to subepithelial nerve repair, and surgical methods, have nothing to do with age factors and infection factors. |
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