水分离时应用三氧化二砷抑制兔眼后囊膜混浊及其眼内毒性的实验研究

Experimental study on using arsenic trioxide in hydrodissection to inhibit the posterior capsule opacification and its intraocular toxicity in rabbit

目的探讨术中水分离时应用三氧化二砷（As2O3）对兔后发性白内障的抑制作用及对兔眼的毒性作用。方法在免眼晶状体囊外摘出术中，应用1mL不同浓度的As2O3（2μmol·L^-1、4μmol·L^-1、8μmol·L^-1）于晶状体囊袋内进行水分离，使其直接短暂作用于晶状体上皮细胞。术后随访12周，裂隙灯观察比较用药组和对照组免晶状体后囊膜混浊、眼压的变化等；并观察术后组织病理学的变化。结果术后2周只有对照组眼出现后囊膜混浊。术后4周用药组眼的后囊膜混浊明显比对照组眼轻，且随药物浓度增高而减轻。中、低浓度组兔眼的术后炎症反应与对照组比较无明显差异。高浓度组兔眼术后早期出现轻微的毒性反应。组织病理学检查表明，对照组的晶状体上皮细胞增生较用药组明显。As2O3可引起晶状体上皮细胞变性，其文化程度与药物浓度有关。高浓度组可引起角膜内皮细胞亚细胞水平可逆性损伤和虹膜睫状体急性炎症反应。结论As2O3能有效的抑制晶状体上皮细胞的增生，其作用强度与药物浓度有关。兔晶状体囊袋内应用2～8μmol·L^-1的As2O3是防治后发性白内障安全有效的荆量浓度。[眼科新进展2007；27（3）：179-183]

Objective To investigate the inhibitive effect of arsenic trioxide （ As203 ） used in hydrodissection on posterior capsule opaciflcation （ PCO ） in rabbits and its intraocular toxicity. Methods In the extracapsular cataract extraction,As2O3 （1 mL）with different concentration （2 μmol·L^-1 ,4μmol·L^-1 and 8 μmol·L^-1） was injected into the capsular bags of lens for the hyclrodissection. The drug was exposed to the lens epithelial cells directly and transiently. The followed-up time after the operation was 12 weeks, the PCO and the change of intraocular pressure were observed and compared between control group and experimental group, the histopathologic and ultrastructual change were also observed. Results At the 2 weeks after operation,the PCO only appeared in the control group. Four weeks after the operation, the PCO in the eyes of experimental group was not so obvious as that of control group,and the higher the concentration of the drug was, the less the PCO showed. There was no obvious difference in the postoperative inflammation between the control group and the low,middle-concentration experimental group. Slight toxic reaction appeared in the eyes of high-concentration experimental group in the early stage the operation . The histopathologic experimental showed that the proliferation of lens epithelial cells in the control group was more obvious than that in the experimental group. As2O3 could cause the degeneration of lens epithelial cells,and the degree was related to the concentration of durg. The reversibility damage of corneal endothelial cells in subeellsular level and the acute inflammation in corpus ciliate choroideae appeared in the eyes of high-concentration experimental group. Conclusion As2O3 can inhibit the proliferation of lens epithelial cells effectively,which is related to the concentration of drug. As2O3 applied in the capsular bag with the concentration of 2 - 8 μmol·L^-1 is safe and effective in inhibiting the PCO. [Ree Adv Ophthalmol 2007;27（3） ：179-183]