兔眼超声乳化术黏弹剂残留对眼压影响的研究

The effects of residual viscoelastic materials on intraocular pressure after phacoemulsification on rabbit eyes

目的探讨不同黏弹剂相同残留量及同一黏弹剂不同残留量兔眼晶状体超声乳化术后眼压的变化。方法兔63只(126只眼),随机分为9组,行透明角膜缘切口晶状体超声乳化术。黏弹剂残留量0.05 mL及0.1 mL。于麻醉前及术后24 h内各时间点测量眼压并进行统计学分析。于眼压高峰期及术后24 h取病理标本进行观察。结果不同黏弹剂相同残留量引起术后早期眼压升高不同,差异有统计学意义(P<0.01)。相同黏弹剂残留量越大,术后早期眼压升高越明显,差异有统计学意义(P<0.01)。病理学观察显示,黏弹剂残留组于术后眼压升高期前房角组织内可见黏弹剂残留,早期视网膜神经节细胞受损害。结论兔眼晶状体超声乳化术中使用不同黏弹剂,术后24小时眼压升高发生率不同,黏弹剂残留对术后眼压升高影响更大。

Objective To investigate the elevation of intraocular pressure （IOP）after uneventful phacoemusification on rabbits eyes using different viscoelastic materials in the same residual vol- ume ,and using the same viscoelastic materials in the different residual volume. Methods 63 rabbits（ 126 eyes）were divided into 9 groups randomly and performed phacoemulsification through transparent corneal margin. After cleaning the viscoelaste materials, 0.05 ml or 0. 1 ml methyl cellulose, Iviz or Hyalaronic Acid （HA） was injected respectively into the capsular bag. The lOP was investigated respectively before and after anesthesia, and different times postoperatively. The eyes were enuculeated at the peak of elevated IOP and 24h after operation in order to perform pathological study and scaning electronic microscopic study. Results With the same residual volume of different visoelastic materials, there was different elevation in lOP in the early stage after surgery . It is significantly different statistically （P 〈0.01 ）. With the same viscoelastic mate- rials, different residual volume resulted in different elevated IOP. The more the residuals, the higher the IOP. It is significantly differ- ent statistically （ P 〈 0.01 ）. The pathological study showed that viscoelastics was observed remained in the anterior chamber angle tissue at the peak period of IOP, and the early damage of retinal ganglion cells could be observed. Conclusion Using different viscoelastic materials during phacoemulsification on rabbits eyes, the resuits of elevation lOP in 24h after operation were different. The volume of residual viscoelastic materials was a very important factor for elevation of post operative IOP.