丝裂霉素C对后囊混浊防治作用的实验研究

Effect of mitomycin C on posterior capsule opacification in rabbit eyes

目的通过兔眼透明晶状体囊外摘出,术中囊袋内灌注药物,观察丝裂霉素C(mitomycin C,MMC)对后囊混浊(posterior capsule opacification,PCO)的影响,并观察其对眼内组织的副作用。方法将8只大白兔随机分为2组,每组4只(8眼)。行透明晶状体囊外摘出术,术中前房内注入透明质酸钠,囊袋内分别灌注生理盐水(A组,对照组)、MMC(B组,实验组,0.1g·L-1)各0.2mL,保留3min,然后环形撕囊,囊外摘出晶状体。术后每日观察并记录早期炎性反应情况,PCO出现的时间及程度;3月后处死动物,抽取房水,测房水细胞及蛋白含量;取下眼球,行HE染色,观察晶状体上皮细胞增殖及眼内组织炎性反应情况。结果术后第1天A、B组结膜充血及前房渗出均较明显,以后逐渐消退,结膜充血平均消退时间分别为(9.25±0.89)d、(9.88±1.13)d,前房渗出时间分别为(6.38±0.92)d、(6.88±1.36)d,2组间无显著性差异(P>0.05)。PCO出现时间、混浊程度,2组之间均有显著性差异(P<0·01)。术后3个月2组房水蛋白含量均较术前明显增高(P<0.01),但无显著性差异。HE染色结果显示2组眼内组织均无炎性细胞浸润。结论晶状体摘除手术可以造成血-房水屏障的破坏,术后3个月仍未完全恢复。MMC在0.1g·L-1能够有效抑制PCO发生,但并不增加对血-房水屏障的影响。

Objective To observe the effect of mitomycin C （MMC） on poster capsule pacification （PCO） and its intraocular toxicity by extracapsular lens extraction（ECLE） combined with intracapsular drug infusion. Methods Eight rabbits were divided into two groups,four cases in each group. ECLE was performed,sodium hyaluronate was injected into the anterior chamber to pro- tect epithelium cell of cornea,0.2 mL NS（group A） ,MMC（0.1 g ·L^-1 ,group B） was injected into intracapsular for hydrodissection, remaining inside for 3 minutes,then continuous circular capsulorhexis was performed. The inflammatory response,time and degree of PCO formation was investigated every day after surgery. Three months after operation, the animal was killed to draw the aqueous humor,the cells and protein in which was examined. After eyeball enucleated ,lens epithelium cells and inflammatory response of intraocular tissues was observed by HE staining. Results The conjunctiva congestion and aqueous humor effusion were all visible on the first day after surgery in A, B groups, and then began to decrease, the disappear time of them in group A were （ 9.25 ± 0. 89） days, （6.38 ±0.92） days,and in group B were （9.88 ± 1.13） days, （6. 88 ± 1.36） days,there were no difference between two group（ P 〉 0.05 ）. There were significant difference in the time and degree of PCO formation between two groups（P 〈 0.01 ）. Three months after surgery, the content of protein in aqueous humor in two groups after surgery were all higher than that before surgery（P 〈 0.01 ） ,but there was no difference between two groups. HE staining showed that there was no inflammatory cells infiltrating the intraocular tissues. Conclusion The operation of ECLE can damage the barrier between blood and aqueous humor,which still do not recovery at three months after surgery. MMC is effective in preventing PCO in dose of 0.1 g · L^-1 without enhancing the damage on the barrier between blood and aqueous humor.