小牛血去蛋白提取物对超声乳化术角膜内皮损伤的修复作用

Rehabilitation function of deproteinized extract of calf blood in phacoemulsification of corneal endothelium

目的:研究小牛血去蛋白提取物(Deproteinized extract ofcalf blood,DECB)作为白内障超声乳化术中冲洗剂和术后留置剂对角膜内皮细胞损伤的修复作用。方法:采用纯种日本大耳白兔24只制作超声乳化白内障摘除术动物模型,右眼为实验组采用加入DECB的BSS(平衡盐灌注液)作为术中冲洗剂和术后留置剂,左眼为对照组采用BSS必施为术中冲洗剂和术后留置剂。术前及术后即刻,术后6,12,24,72,168h分别裂隙灯下观察角膜;使用接触型角膜内皮反射显微照相系统定量分析内皮细胞平均面积(average size)、变异系数(coefficient ofvariability)、细胞密度(cell density);术后即刻,术后24,72h行内皮细胞染色计算内皮细胞活性率;术后6,24h、术后3d取实验兔角膜行透射电子显微镜观察。结果:术后裂隙灯下实验组和对照组兔角膜无明显差别;术后即刻、术后6,12h角膜内皮平均面积,变异系数和内皮细胞密度(P<0.05),差异有统计学意义;术后72h,角膜内皮细胞平均面积,变异系数,差异有显著统计学意义,内皮细胞密度(P<0.05);术后168h角膜内皮细胞平均面积,变异系数和内皮细胞密度差异没有统计学意义。术后透射电子显微镜观察实验组和对照组兔角膜内皮细胞超微结构:实验组细胞损伤明显轻于对照组。

AIM： To study the effect of deproteinized extract of calf blood （DECB） in the phacoemulsification on corneal endothelium as irrigate and detain agent. METHODS： Twenty-four albino rabbits were prepared for animal model by phacoemulsification. Their right eyes and left eyes were experiment group and control group, with he irrigate and detained agent being BSS balance salt added DECB and BSS balance salt only, respectively. Before operation and postoperative 0, 6, 12, 24, 72, 168 hour, corneal was observed through slit-lamp, the corneal endothelium was quantitative analyzed through corneal endothelium image micrograph system, and the fine structure of corneal endothelium was observed by transmission electron microscope. RESULTS： The two groups had not significant difference on slit-lamp examine. At 0, 6, 12 hours after operation, there were significant difference on the average size of corneal endothelium, coefficient of variability and cell density between the two groups （P〈0.05）. At 168 hours postoperation, the average size of corneal endothelium, coeffident of variability and cell density were not significantly different between the two groups. The cell damage is less severe in experiment than in the controls. CONCLUSION： DECB can improve the rehabilitation of corneal endothelium cells in phacoemulsification.