新型医用黏合剂治疗角膜穿通伤对眼前节的影响

Effect of improved medical tissue adhesive for corneal penetrating wound on ocular anterior segment

目的探讨医用组织黏合剂治疗角膜穿通伤对眼前节的刺激反应,及对角膜内皮细胞和血-房水屏障功能的影响。方法 20只日本大耳白兔建立角膜穿通伤模型,右眼采用医用胶黏合、左眼采用缝线缝合术,术后大体观察兔眼前节情况;角膜共聚焦显微镜观察角膜内皮细胞形态和密度变化,抽兔眼房水行房水蛋白含量测定,透射电镜观察内皮细胞超微组织结构变化。结果术中和术后各时间点医用胶组和缝线组角膜伤口均密闭。两组术后不同时间点角膜共聚焦显微镜观察角膜穿通伤口周边内皮细胞形态和密度无明显差异。房水蛋白含量在术后7d均为最高,医用胶组和缝线组分别为(0.561±0.284)g·L-1、(0.523±0.303)g·L-1,随伤口愈合术后90d恢复正常,各观察时间点两组间差异均无统计学意义(均为P>0.05)。透射电镜观察角膜内皮细胞示:术后14d细胞超微结构基本正常,两组均可见细胞内少量粗面内质网扩张,空泡稍增多,线粒体肿胀;术后30d均恢复正常。结论医用组织黏合剂治疗角膜穿通伤口组织相容性好,对眼前节无明显刺激反应和异物反应。

Objective To investigate the histocompatibility of chemical tissue adhesive on ocular anterior segment for corneal penetrating wound, and study the effect on corneal endothelial cells and blood-aqueous humor barrier. Methods The corneal penetrating wound models were established in 20 Japanese white rabbits, the 2-Octyl Cyanoacrylate adhesion was performed in the left eyes, and the suturing surgery in right eyes. The anterior ocular segment was observed after operation,the morphous and den- sity of corneal endothelial cell were observed by corneal confoeal microscopy, the pro- tein level in aqueous humor was detected, and the ultrastrncture of corneal endothelial cell was observed by transmission electron microscope. Results The penetrating wounds in two groups were all closed in operation or at different time points after oper- ation. There was no difference in the morphous and density of corneal endothelial cell a- round the corneal penetrating wound at different time points after operation between two groups. The protein level in aqueous humor at 7 days after operation in two groups was the highest,which were （0. 561 ±0. 284） g · L^-1 and （0. 523 ± 0. 303 ） g · L^-1 , re turned to normal at 90 days after operation, there was no statistical difference at differ- ent time points between two groups （ both P 〉 0.05 ）. Transmission electron microscope showed,the ultrastructure at 14 days after operation was normal, few rough endoplasmie retieulum were enlarged in two groups, the vacuoles was increased and the mitoehondria were swollen, which returned to normal at 30 days after operation. Conclu- sion 2-Octyl Cyanoacrylate for corneal penetrating wound has better histoeompatibili- ty with no obviously stimulus response and foreign body reaction.