盐酸丙美卡因滴眼液对兔眼中央角膜厚度及角膜上皮形态学的影响

Effects of proparacaine hydrochloride eye drops on central corneal thickness and corneal epithelial morphology of rabbit

目的研究5g.L-1盐酸丙美卡因(proparacaine Hydrochloride,PH)滴眼液对兔眼中央角膜厚度(central corneal thickness,CCT)及角膜上皮层的影响。方法取新西兰大白兔20只,全部随机选择一眼进行实验,先后使用Pentacam三维眼前节分析诊断系统、A型超声角膜测厚仪测量CCT并记录,取其均值作为基准CCT。在兔眼结膜囊内滴入1滴5g.L-1PH滴眼液后1min、3min、6min、9min、12min、15min、18min、21min先后使用以上两种方法测量其CCT值并记录。同时在滴表面麻醉药前和滴表面麻醉药后各时间段采用共聚焦显微镜观察角膜上皮层是否有形态学变化。结果滴PH前Pentacam、A超所测基准兔眼CCT分别为(350.50±16.40)μm、(330.65±17.08)μm。滴PH后Pentacam所测CCT在1min时为(362.00±16.74)μm,与滴前比较差异有统计学意义(P<0.05),3min时为(354.80±17.79)μm,与滴PH前比较差异无统计学意义(P>0.05),以后各时间点CCT均未见明显变化(P>0.05)。A超在滴PH前后CCT均未见明显变化(均为P>0.05)。共聚焦显微镜下显示滴PH前后角膜上皮细胞有变化,呈现轻微水肿特征,角膜其他各层结构均未见明显变化。结论 Pentacam在评估角膜测厚方面具有较好的可重复性及稳定性;5g.L-1PH滴眼液对兔眼Pentacam测量在1min内有影响,对A超则影响不明显;兔眼在滴用5g.L-1PH滴眼液3min后使用Pentacam测量角膜厚度更为合理;5g.L-1PH滴眼液可引起兔眼角膜浅表上皮细胞层形态学改变,可在24h内恢复。

Objective To study the effects of 5 g L-1 proparacalne hydrochlo- ride （PH） eye drops on rabbit＇ s central corneal thickness（CCT） and corneal epithelial morphology. Methods Each side of eye was randomly chosen and marked in 20 rab- bits,then the general anesthesia were performed. CCT was consecutively measured by Pentacam scheimpflug device and A ultrasound before application of PH. Then, CCT was measured consecutively at 1 minutes,3 minutes,5 minutes,9 minutes,12 minutes,15 mi- nutes, 18 minutes and 21 minutes using above two methods after application of 5 g L-1 PH. Before and after application of PH at different time points,in vivo confocal micros- copy were used to observe the changes of corneal epithelial morphology, lbesults Be- fore application of PH,Benchmark of CCT measured by Pentacam and ultrasound were （350.50 ± 16.40） μm and （330.65 ± 17.08）μm. At 1 minute after application of PH,CCT measured by Pentacam was （352.00± 16.74） μm,there was statistical difference com- pared with that before application （P 〈 0.05 ）. At 3 minutes after application of PH, CCT was （354.80± 17.79） μm, there was no statistical difference compared with that before application（P 〉 0.05 ）. CCT in sub- sequent time periods showed no significant change （P 〉 0.05 ）. However, there was no statistical difference in CCT meas- ured by A ultrasound before and after application of PH（ both P 〉 0.05 ）. There was mild change of the epithelial cells before and after application of PH observed by in vivo confocal microscopy, which showed mild edema, and structure of other cor- neal layers did not show any significant change. Conclusion Pentacam have good reproducibility and stability in assess- ing corneal thickness. Measurement results of Pentacam can be affected by 5 g L -1 PH eye drops within 1 minute, howev- er, we can hardly see 5 g L-1 PH has effect on Ultrasound pachymetry. It＇ s more reasonable to measure rabbit corneal thickness by Pentacam 3 minutes after application of 5 g L- 1 PH eye drops. 5 g L-1 PH eye drops can induce morphologi- cally changes of the rabbit corneal superficial epithelial cell layer, which can recover within 24 hours.