带虹膜隔折叠式人工晶状体植入兔眼的初步观察

Preliminary investigation on the implantation of foldable iris-diaphragm intraocular lens in rabbits

目的观察新型带虹膜隔折叠式人工晶状体(intraocular lens,IOL)植入兔眼的手术切口及术后反应,评价其与现有IOL的差异。方法新西兰大白兔20只(20只眼),沿瞳孔缘剪除部分虹膜,行晶状体超声乳化吸除术。然后将其随机分为空白对照组、常规折叠式IOL植入组、Morcher虹膜隔硬性IOL植入组、带虹膜隔折叠式IOL植入组,每组5只眼。术后1周、2周、1个月和3个月用裂隙灯显微镜观察并拍照,术后1周检测各组角膜内皮细胞密度,术后3个月取出IOL并行扫描电镜检查,实验眼行组织病理学检查。结果手术切口大小:空白对照组与常规折叠式IOL植入组为2.6mm,Morcher虹膜隔硬性IOL植入组为10mm,带虹膜隔折叠式IOL植入组为5mm。随访期间各组IOL均居中并保持原透明度。带虹膜隔折叠式IOL植入后的前房炎性反应重于空白对照组及常规折叠性IOL植入组,相比Morcher虹膜隔硬性IOL植入组则略有减轻。带虹膜隔折叠式IOL植入组在术后3个月可见周边虹膜色带略变浅,并有1例出现IOL襻移位。结论新型带虹膜隔IOL可明显减少同类型IOL手术切口的大小,但需在材料的生物相容性、襻支撑性和虹膜隔色彩持久度方面进一步改进。

Objective To investigate the incision and surgical effects of implantation of the newly invented foldable iris-diaphragm intraocular lens（IOL） in rabbits, comparing with those of other kind of IOL which has been used in clinic. Methods Twenty eyes of 20 rabbits received phacoemusification and iridectomy, and then were divided into 4 groups according to their implantation of different types of IOL： control group （no IOL implanted）, ordinary foldable IOL group, Morcher unfoldable black iris-diaphragm IOL group and foldable iris-diaphragm IOL group. Slit-lamp observation was performed at 1 week, 2 weeks, 1 month and 3 months after surgery respectively. Corneal endothelial cell density was examined 1 week after surgery. Hematoxylin eosin staining of the eyeball and scanning electron microscope examination was performed 3 months after the surgery. Results The incision of control group and ordinary foldable IOL group was 2.6 mm, Morcher IOL was 10 ram, and of foldable iris-diaphragm IOL group was 5 mm. All IOLs maintained their position and transparency. The inflammatory reaction of foldable iris-diaphragm IOL was more severe than that of the control group and ordinary foldable IOL, but lower than Morcher IOL. The color of iris-diaphragm faded a little 3 months after surgery in foldable iris-diaphragm IOL. One case of foldable iris-diaphragm IOL showed dislocation of one haptic. Conclusions The foldable iris-diaphragm IOL could make the incision much smaller than unfoldable iris-diaphragm IOL. But its biocompatibility, sustaining of haptics and stability of color in iris-diaphragm should be improved. （ Chin J Ophthalmol and Otorhinolaryngo1,2011,11：9-12）