超声乳化术中不同灌注液对角膜内皮细胞的影响

Effects of different irritating solutions on corneal endothelium during phacoemulsification

目的:观察超声乳化术中使用不同灌注液(世可和平衡盐液)对兔眼角膜内皮细胞结构及功能的影响。方法:3.5月龄纯种日本大耳白兔,随机分为正常对照组、空白对照组、世可组和平衡盐液组,采用接触性角膜内皮显微镜进行角膜内皮细胞形态学定量测定。锥兰-茜素红活性染色,观察各组角膜内皮细胞微细结构的变化。结果:术后6h,各组较正常对照组细胞密度和六边形细胞百分率降低;细胞面积和六边形细胞百分率均高于正常对照组;光镜显示空白对照组角膜内皮细胞形态改变明显,而世可组和平衡盐液组角膜内皮细胞改变轻微,无细胞坏死。结论:在超声乳化术中,灌注液对角膜内皮的损伤为化学性损伤,在相同手术条件下,世可对角膜内皮细胞具有良好的保护作用。

Objective： To observe the different effects of Shike solution and balanced salt solution （BSS） on the corneal endothelium during phacoemulsification. Methods： Sixteen Japanese flap-eared rabbits （aged 3.5 months, weighing 1. 8- 2.0 kg） were equally randomized into 4 groups： normal control group using the normal rabbit corneal endothelium, blank control group using sodium chloride as irrigating solution, Shike group and BSS group. Contact specular microscopy was used to evaluate the morphological index of the corneal endothelium including endothelial cell density, cell area, and percentage of hexagonal cells and coefficient of variation preoperatively. At 6 h after operation, the corneae of each group were dyed by 0. 250/oo typan blue and 0.20/oo alizarin red S. Endothelial cells were examined by light microscopy. Results： All the 16 rabbits were included in result analysis. There were no significant differences in the morphological index before operation among the four groups. At 6 h after operation, the endothelial cell density and percentage of hexagonal cells was lower, cell area and coefficient of variation was higher in other three group than in the normal group （P〈0.05）. There was no significant difference between Shike group and BSS group. The structural change of the corneal endothelium in Shike group and BSS group was more palliative than that in the blank control group. Conclusion： Under the same operation conditions, Shike is as effective as BSS in protecting corneal endothelial cells