Особенности морфологических изменений биоптатов конъюнктивы, полученных с использованием фемтосекундного лазера

Abstract

Purpose. To give a morphological assessment of human conjunctival biopsies obtained manually and using a femtosecond laser. Material and methods. Morphological studies were carried out in 4 groups of patients with pterygium who underwent autoplasty with a bulbar conjunctival flap. In groups 1–3 conjunctival biopsies with a thickness of 70, 80 and 100 microns respectively, were obtained using a femtosecond laser, in group 4 – a flap of the minimum possible thickness was cut out manually. Conventional methods of preparing histopreparations with hematoxylin-eosin staining and the Van Gieson method were used. Results. A feature of the manual technique for preparing a conjunctival graft is the formation of a flap with insufficiently smooth edges, uneven and unpredictable thickness. In the structure of such biopsies, violations of the continuity of cell layers, areas of epithelial rupture were noted. During the formation of a flap with a thickness of 80 and 100 microns using a femtolaser, morphological changes were noted in the form of destruction of epithelial cells, the appearance of foci of coagulation in the epithelial layer and cavitation vesicles in the connective tissue stroma. The severity of pathological changes increased as the depth of the conjunctival incision increased, which may be due to the use of a higher power of the femtolaser for this purpose. The smallest pathohistological changes in the conjunctival biopsies of the eyeball were observed when receiving a femto flap 70 microns thick. Conclusion. The use of various methods (manual technique or femtolaser) for obtaining a conjunctival transplant does not exclude the use of each of them in practical medicine. The femtolaserassisted technique makes it possible to obtain ultra-thin flaps that can be fixed seamlessly, in particular with fibrin glue. Key words: conjunctival biopsy, morphological examination, femtosecond laser, pterygium