不同剂量全氟萘烷对兔角膜组织生物耐受性的影响

Effects of various amounts of perfluorodecalin on the biological tolerance of rabbit cornea

背景:目前气体、硅油等玻璃体长期替代物置入后的效果均不理想,全氟萘烷是否能作为玻璃体长期替代物有待证实。目的:观察兔角膜对不同剂量全氟萘烷的生物耐受性。设计、时间及地点:随机分组设计、动物对照观察,于2006-04/10在石河子大学第一附属医院动物实验中心和石河子大学病理学实验室完成。材料:清洁级新西兰白兔24只,全氟萘烷由上海华捷视医疗设备有限公司提供。方法:将24只兔按随机数字表法分成3组,0.15mL全氟萘烷组(16只),0.02mL全氟萘烷组(4只),对照组(4只),行前房穿刺,分别注入0.15,0.02mL全氟萘烷,0.15mL平衡盐液。主要观察指标:术前及术后不同时点行裂隙灯眼前段检查,分别于术后3d,1,2,4,6,8周摘取眼球观察眼部体征及角膜组织学变化。结果:0.15mL全氟萘烷组下方角膜水肿,前房闪辉(+),纤维素性渗出。苏木精-伊红染色显示对照组术后8周角膜结构正常。0.02mL全氟萘烷组术后8周角膜内皮细胞水肿,胞浆内出现空泡,角膜基质内有少量炎症细胞浸润。0.15mL全氟萘烷组术后3d,下方少量角膜内皮细胞空泡变性,基质内有少量炎症细胞浸润。下方角膜内皮细胞随时间的推移损伤加重。术后8周,5只兔眼下方大量角膜内皮细胞出现变性崩解、实质水肿、角膜深层基质新生血管及炎症细胞浸润,而上方角膜内皮细胞及基质正常。锥虫蓝-茜素红角膜内皮联合染色也证实了0.02mL全氟萘烷对角膜有轻度损伤。结论:0.02mL全氟萘烷可能接近兔眼的生理耐受量。

BACKGROUND： At present, gas and silicone oil are not ideal as a long-term vitreous tamponade, perfluorodecalin needs to be elucidated. OBJECTIVE： To observe the biological tolerance of rabbit cornea in response to various amounts of perfluorodecalin. DESIGN, TIME AND SETTING： Randomized control animal experiments were completed in animal experiment center of the First Affiliated Hospital of Shihezi University and pathology laboratory of Shihezi University from April to October in 2006. MATERIALS： Twenty-four New Zealand rabbits of clean grade were used in this study, Perfluorodecalin liquids were offered by Shanghai Huajieshi Medical Device Co., Ltd. METHODS： Totally 24 rabbits were divided into three groups by randomization： 0.15 mL perfluorodecalin group （n=16）, 0.02 mL perfluorodecalin group （n=4）, and control group （n=4）. Subsequent to the puncture of anterior chamber, 0.15 mL and 0.02 mL perfluorodecalin group were injected with 0.15 mL and 0.02 mL perfluorodecalin homologically, control group were injected with 0.15 mL balance salt solution. MAIN OUTCOME MEASURES： At preoperative and postoperative different time points, anterior segment of eyes was determined by slit lamp. The eyes were enucleated and the histological examination was performed on day 3 and weeks 1, 2, 4, 6 and 8 postoperatively. RESULTS： In the 0.15 mL perfluorodecalin group, there were inferior corneal edema, aqueous flare （＋） and cellulose exudation. Hematoxylin-eosin staining showed corneal structure was normal at 8 weeks in the control group. In the 0.02 mL perfluorodecalin group, there were corneal endothelium edema, vacuolus intracytoplasm, and a small quantity of inflammatory cell infiltrated in corneal stroma. At 3 days, the inferior corneal endothelial cell vacuolus degenerated in the 0.15 mL perfluorodecalin group, and a small quantity of inflammatory cells infiltrated in corneal stroma. The damage of the inferior corneal endothelial cells aggravated with time passing. At 8 weeks, a great quantity of inferior corneal endothelial cells in 5 eyes showed degeneration and disintegration, stroma edema, new vessels of deep layer corneal stroma and inflammatory cells infiltration, but superior corneal endothelial cells were normal. Trypanblau-chinalizarin staining confirmed that 0.02 mL perfluorodecalin also injured cornea. CONCLUSION： The biological tolerant threshold for rabbit eye might be close to 0.02 mL perfluorodecalin.