纤溶酶和分散酶诱发兔眼玻璃体后脱离

Plasmin and dispase in inducing posterior vitreous detachment in rabbit eyes

目的：评价纤溶酶和分散酶诱发玻璃体后脱离(PVD)的安全性和有效性。方法：48只兔均分6组。组1,5眼内注射分散酶0.025 U,组2为0.1 U；组3,6注射纤溶酶1 U,组4为4 U。组5,6术后15 min取眼球行组织化学检测,其余组术后7 d内行临床检查、视网膜电流图(ERG)及扫描、透射电镜检测。结果：扫描电镜证实组1,2,4均能诱发出部分或完全性PVD(8/8,8/8,8/8),除组3(6/8)。组5,6组织化学显示均发生眼内炎(8/8,8/8)。ERG显示组1,2暗适应眼最大电反应的a,b波振幅均显著下降(均P＜0.01),组3,4无显著改变(均P＞0.05)。组1,2眼出现视网膜结构损伤、视网膜出血和白内障发生。结论：眼内注射纤溶酶和分散酶均能诱发出PVD,前者眼内毒性反应小,后者大。

AIM： To evaluate the safety and efficacy of dispase and plasmin inducing posterior vitreous detachment （PVD） by intravitreal injection in rabbit eyes. METHODS： Forty-eight pigmented rabbits were randomized into 6 groups. Groups 1 and 5 received dispase 0.025 U in each of testing eye;group 2, dispase 0.1 U; groups 3 and 6, plasmin 1 U;group 4, plasmin 4 U. All groups received PBS in control eyes. Groups 5 and 6 were enthanized 15 minutes postoperatively for ocular histological examination. The remaining groups received clinical inspection, indirect ophthalmoscope, biomicroscopy, electroretinogram （ERG）, together with scanning and transmission electron microscopy seven days postoperatively. RESULTS： Scanning electron microscopy revealed partial or complete PVD in the eyes which received dispase and plasmin in groupl, 2, 4（8/8, 8/8, 8/8）, except group 3 （6/8）. Light microscopy showed inflammation changes in both dispase and plasmin treated eyes of group 5 and 6（8/8, 8/8）. However, ERG showed no significant change of dark adaptation eye a and b （P 〉 0.05） in plasmin treated eyes（group 3, 4）, and a significant reduction from baseline （P 〈 0.01 ） in dispase treated eyes （group 1, 2）. The ultrastructure damage of retina were found by transmission electron microscopy. Cell damage, retinal hemorrhage, and cataract formation were observed in eyes of group 1 and 2. No changes were observed in plasmin treated and the control eyes. CONCLUSION： Intravitreal injection of plasmin and dispase could induce PVD, but with lesser toxicity in case of the former than that of the latter.