联合抗肿瘤药物预防免疫后发性白内障的实验研究(简报)

In vivo experimental study on the prevention of after cataract by using 5-fluorouracil in combination with mitomycin C in the capsular bags of the rabbits′ lens

Objective To evaluate the efficacy of rabbit lens capsular bag by using 5-fluorouracil(5-FU) in combination with mitomycin C (MMC) in preventing posterior capsule opacification (PCO) and its mechanism. Methods Forty New Zealand rabbits (80 eyes) received continuous curvilinear capsulorhexis (CCC,its diameter approximately 3 millimete) and phacoemulsification,and were randomly divided into 2 groups:The right eyes of the rabbits lens capsular bags of the experimental group (twenty New Zealand rabbits)were in jected with methylcellulose (MC) contained 12.5 mg/ml 5-FU and 0.2mg/ml MMC,and the left eyes of that were injected with only MC as vacuity control group;While the right eyes of the rabbits lens capsular bags of the control group (twenty New Zealand rabbits) were injected with methylcellulose (MC) contained 0.2mg/ml MMC,and the left eyes of that were in jected with MC contained 12.5 mg/ml 5-FU.The anterior chamber of all subjects were filled with sodium hyaluronate (HA).Five minuts late,the anterior chambers and lens capsular bags of all subjects were permutated by irrigating solution.Some of the subjects were implantated intraocular lens (IOL) in lens capsular bags.In the two-month to twenty-month follow-up after the operation,all eyes were examined by slit-lamp microscopy,the PCO were observed and compared between the two groups;the histopathologic examination of the lens capsule membran and IOL,the wholemount technique of the lens capsule membran,the electron microscope inspection of the IOL were also observed in different period. Results For clinical study,the PCO appeared in the vacuity control group two weeks after the operation.Some of the psuedophakic subject were formed frontal membrane of the IOL.The longer follow-up after the operation,the stronger PCO were taken place.The PCO did not appeare any more in the experimental group twenty-month follow-up after the operation,while the control group appeare somewhat of a PCO.The histopathologic examination showed that the proliferation of lens epithelial cells(LEC) in the vacuity control group was more obvious than that of the control group and experimental group.In the experimental group,the LEC away from central area (diameter approximately 3 millimete) occur vacuolation,karyopyknosis and cytolysis one month after the operation,but two months after the operation,all the LEC were extinction;In the vacuity control group,the LEC proliferation were taken place one month after the operation,for time going,soemmeting ring and the lens capsule membran fibrosis and capsular bag shrinkage were also taken place;In the vacuity control group,the LEC away from central area (diameter approximately 3 millimete)may occur vacuolation,karyopyknosis or even more cytolysis one month after the operation,but two months after the operation,the LEC occur proliferation again,then the lens capsule membran fibrosis.The lens capsule wholemount examination manifested stained preparation steady,there was no cell and fiber on the wholemount in the experimental group,but adverse in the vacuity control group and control group.The scanning electron microscope study showed that the IOL in the experimental group were smooth and clean compared with the vacuity control group and control group. Conclusion Using 5-FU in combination with MMC in the rabbit lens capsular bag may effectively kill the LEC and equator of lens cells in different way,and also prevent the lens capsule membran fibrosis and capsular bag shrinkage,therefore prevent PCO.Symphysial medication may be effectively prophylactic treatment of PCO.The wholemount technique is a very usefull method to assess experimental PCO.5-FU in combination with MMC in the human lens capsular bag administration may be a promising method in the prevention of posteror capsule opacification.

Objective To evaluate the efficacy of rabbit lens capsular bag by using 5-fluorouracil （5-FU） in combination with mitomycin C （MMC） in preventing posterior capsule opacification （PCO） and its mechanism. Methods Forty New Zealand rabbits （80 eyes） received continuous curvilinear capsulorhexis （CCC, its diameter approximately 3 millimete） and phacoemulsification, and were randomly divided into 2 groups ： The fight eyes of the rabbits lens capsular bags of the experimental group （twenty New Zealand rabbits） were in jeeted with methylcellulose （MC） contained 12.5 mg/ml 5-FU and 0. 2mg/ml MMC, and the left eyes of that were injected with only MC as vacuity control group; While the right eyes of the rabbits lens capsular bags of the control group （ twenty New Zealand rabbits ） were injected with methylcellulose （ MC ） contained 0.2mg/ml MMC, and the left eyes of that were in jected with MC contained 12. 5 mg/ml 5-FU. The anterior chamber of all subjects were filled with sodium hyaluronate （HA） . Five minuts late, the anterior chambers and lens capsular bags of all subjects were permutated by irrigating solution. Some of the subjects were implantated intraocular lens （IOL） in lens capsular bags. In the twomonth to twenty-month follow-up after the operation, all eyes were examined by slit-lamp microscopy, the PCO were observed and compared between the two groups; the histopathologic examination of the lens capsule membran and IOL, the wholemount technique of the lens capsule membran, the electron microscope inspection of the IOL were also observed in different period. Results For clinical study, the PCO appeared in the vacuity control group two weeks after the operation. Some of the psuedophakic subject were formed frontal membrane of the IOL. The longer follow-up after the operation, the stronger PCO were taken place. The PCO did not appeare any more in the experimental group twenty-month follow-up after the operation, while the control group appeare somewhat of a PCO. The histopathologic examination showed that the proliferation of lens epithelial cells （LEC） in the vacuity control group was more obvious than that of the control group and experimental group. In the experimental group, the LEC away from central area （ diameter approximately 3 millimete） occur vacuolation, karyopyknosis and cytolysis one month after the operation, but two months after the operation, all the LEC were extinction; In the vacuity control group, the LEC proliferation were taken place one month after the operation, for time going, soemmeting ring and the lens capsule membran fibrosis and capsular bag shrinkage were also taken place; In the vacuity control group, the LEC away from central area （diameter approxi- mately 3 millimete） may occur vacuolation, karyopyknosis or even more cytolysis one month after the operation, but two months after the operation, the LEC occur proliferation again, then the lens capsule membran fibrosis. The lens capsule wholemount examination manifested stained preparation steady, there was no cell and fiber on the wholemount in the experimental group, but adverse in the vacuity control group and control group. The scanning electron microscope study showed that the IOL in the experimental group were smooth and clean compared with the vacuity control group and control group. Conclusion Using 5-FU in combination with MMC in the rabbit lens capsular bag may effectively kill the LEC and equator of lens cells in different way, and also prevent the lens capsule membran fibrosis and capsular bag shrinkage, therefore prevent PCO. Symphysial medication may be effectively prophylactic treatment of PCO. The wholemount technique is a very usefull method to assess experimental PCO. 5-FU in combination with MMC in the human lens capsular bag administration may be a promising method in the prevention of pos teror capsule opacification.