疏水丙烯酸酯囊袋张力环的制作及其对晶状体上皮细胞生长和后囊膜混浊的抑制作用

Hydrophobic acrylic capsule tension ring and its inhibition to human lens epithelial cells and posterior capsule opacification

目的研制以疏水丙烯酸为材料直角矩形设计的囊袋张力环(capsule tension ring,CTR),对其生物相容性进行鉴定,观察其在体外对人晶状体上皮细胞(human lens epithelial cells,HLEC)的生长抑制作用及在兔眼中抑制后囊膜混浊(posterior capsule opacification,PCO)的效果。方法将甲基丙烯酸苯乙酯和丙烯酸苯乙酯按一定比例聚合成疏水丙烯酸酯,进一步加工成直角矩形设计、闭合直径10.5mm、宽0.5mm、高0.2mm的开放式CTR,并对其进行细胞毒性试验、热原试验、眼刺激试验等生物相容性测试。取白内障术中前囊膜进行原代HLEC培养,将第2代细胞接种于CTR内进行细胞实验,观察其对细胞的移行作用。动物实验选用青紫兰兔,对照组4只仅接受白内障超声乳化吸出术;实验组4只接受白内障超声乳化同时植入CTR,观察术后炎症反应及前、后囊膜混浊情况。结果细胞毒性为1级,热原试验中试品个体升温均在0.6℃以下,且升温总值为0.1℃,眼刺激试验无异常,证明该材料有较好的生物相容性。体外细胞实验中,所有环均未见有细胞在环上生长或越过环向外生长。兔眼实验中,所有术眼术后均出现不同程度的前房渗出,1～2周基本吸收,术后1个月观察发现实验组兔眼的后囊膜均保持清晰,对照组兔眼的后囊膜出现不同程度的PCO。结论兔眼白内障术中植入疏水丙烯酸材料CTR可以降低PCO的发生。

Objective To study biocompatibilities of a capsule tension ring（CTR） made of hydrophobic acrylic material with sharp square-edge,and observe its mechanical barrier effects to human lens epithelial cells（HLEC） in cell culture system and posterior capsule opacification（PCO） inhibitory effects in rabbit models.Methods The phenethyl methacrylate and phenethyl acrylate were polymerized into hydrophobic acrylate according to the published references and manufactured into a sharp square-edged CTR with an close diameter of 10.5 mm,width of 0.5 mm and thickness of 0.2 mm.Biocompatibility tests,such as cytotoxicity,pyrogenic reactions and irritation were done.Primary culture of HLEC was established by the anterior capsule of human cataract surgery.The second passage of HLEC was incubated into a closed CTR to observe the mechanical barrier effect in vitro.The phacoemulsification with CTR implantation was done to observe the PCO inhibitory effects in vivo.Eight rabbits were divided into 2 groups randomly.Control group（4 rabbits） accepted phacoemulsification only;CTR group（4 rabbits） accepted phacoemulsification and CTR implantation.The postoperative inflammation,anterior capsule opacification and PCO were observed and evaluated.Results Cytotoxicity,pyrogenic reactions and irritativeness tests indicated that hydrophobic acrylic material has good biocompatibility.Reaction scale of cytotoxicity was 1 level.In pyrogenic reactions,the value of each rabbit＇s increasing temperature in hydrophobic group was below 0.6 ℃ and the total value was 0.1 ℃.Irritation test was normal.The HLEC migration was interrupted by CTR in vitro.All rabbits showed exudation in anterior chamber which can be absorbed in 1 week to 2 weeks;The posterior capsule were clear in CTR group at 1 month after operation while the PCO were developed in control group.Conclusion Hydrophobic acrylic CTR with sharp square-edge can reduced incidence of PCO in cataract surgery.