全氟全氢菲在猕猴玻璃体腔内充填的实验研究

Experimental evaluation of perfluoroperhydrophenanthrene (vitreon) as a high specific gravity vitreous substitute in rhesus monkey

目的:评估 全氟全氢 菲(perfluoroperhydrophenan-threne,即 vitreon)在猕猴玻璃体腔内充填对视网膜的毒性作用和眼前段的影响。方法:对 4 只猕猴 8 眼进行三通道玻璃体切除术,术毕于 1 眼玻璃体腔内注入平衡盐液作为对照,在7 眼内注入 vitreon1mL 分别达术后 2,4wk (各 2眼),,,9wk(各 1 眼)。观察术后眼前段和玻璃体 5 6腔内炎症反应,测量术前、术后眼压,并做荧光素眼底血管造影检查,最后对视网膜组织行光镜和透射电镜检查。结果:所有眼在术后1wk内均表现为轻度的炎症反应,vitreon在玻璃体腔内形成分散的小泡。整个实验过程角膜和晶状体均透明。术后眼压与术前相比无显著变化。各时期荧光素眼底血管造影显示无血管渗漏,光镜检查视网膜大体结构和房角结构正常,透射电镜显示vitreon在玻璃体腔内存留2wk时上、下方视网膜内节即出现线粒体肿胀,下方视网膜双极细胞和神经节细胞轻度肿胀,且随充填时间延长损害加重。经统计学分析,上、下方视网膜损害差别无显著性意义(P >0.05)。结论:全氟全氢菲在猕猴玻璃体腔内存留9wk对眼前节和视网膜微循环没有影响。充填2wk可致视网膜超微结构的改变,损害主要累及视网膜内节和双极细胞、神经节细胞,故不适于术后较长时间的充填。

AIM: To evaluate the effects on anterior and posterior segments of experimental vitreous substitution with perfluoroperhydrophenanthrene (vitreon) in rhesus monkey eyes.· METHODS: Seven rhesus monkey eyes underwent vitrectomy and vitreous replacement with vitreon, and another 1 eye served as the control with balance salt solution. The vitreon remained in vitreous cavity for 2-9wk. Clinical examinations, fluorescein angiogram, and pathological examinations of the eyes were performed 2,4,5,6,9wk after insertion of tamponade.· RESULTS: Clinical examination of the eyes with vitreon revealed a mild-to-moderate anterior chamber and vitreous cavity inflammatory reaction during the first week. The reaction was alleviated 2wk after the surgery. Small globules in vitreous cavity appeared 1wk after surgery. All cornea remained clear throughout the experimental period except vitreon entered into the anterior chamber in 1 eye. The lens were clear except one which was touched during surgery. The intraocular pressure were normal in all stages. Fluorescein angiogram of these eyes showed there was no dye leakage from the retinal vessels. Light micrograph of the retina appeared normal from 2 to 9wk after vitreon injection. Electron micrograph of the upper and inferior retina showed that the ridge of the mitochondria of the inner segment broken and that of the inferior retinal bipolar cell and ganglion cell swelled 2wk after vitreon injection. Electron micrograph of the inferior retina 5wk after the surgery showed the intracytoplasmic vacuole of the RPE cell. These damage gradually became heavier with time. The difference of damage in the upper and inferior retina was not statisically significant (P > 0.05). · CONCLUSION: Vitreon injected into the vitreous cavity of rhesus monkey has no toxic effect on cornea and lens. Damages to the retina were observed 2wk after vitreous replacement with vitreon. It is unsuitable for long-term vitreon remain in vitreous cavity.