不同眼内灌注液对兔角膜内皮细胞的影响

COMPARATIVE EFFECTS OF DIFFERENT INTRAOCULAR IRRIGATING SOLUTIONS ON CORNEAL ENDOTHELIUM IN RABBITS

内眼手术中使用的眼内灌注液对角膜内皮细胞可产生损害 ,不同的灌注液可产生不同的影响 ,对临床常用的眼内灌注液 (乳酸钠林格氏液和平衡盐溶液 (BSS) )进行动物实验 ,以观察其对角膜内皮细胞的影响 .对 10只新西兰白兔作前房穿刺 ,放置特制的前房灌洗针进行 2h持续灌注 ,左眼采用乳酸钠林格液 ,右眼采用BSS ;灌注前、灌注后 5min、10min、2 0min每 10min用超声角膜测厚仪测定中央角膜厚度 .2h后取下角膜作扫描电镜及透射电镜观察内皮细胞形态及结构改变 .结果显示 ,两组间角膜平均水肿速率及水肿程度明显不同 .BSS组平均角膜水肿速率为 0 .4 2 33μm /min ,而乳酸钠林格氏液组平均角膜水肿速率达 0 .74 2 6 μm/min ,两组统计学上有极显著性差异 .扫描电镜及透射电镜均显示BSS组灌注 2h后角膜内皮细胞轻微水肿 ,但基本保持细胞形态 ,损害轻微 ;而乳酸林格氏液组角膜内皮细胞肿胀明显 ,内皮细胞变性、坏死、脱落明显 ,损害严重 .

Different intraocular irrigating solutions had different effects on the corneal endothelium when they were used during surgery. This study was to investigate the effects of two intraocular irrigating solutions(lactated Ringer solution and balanced salt solution,BSS) on the corneal endothelium in rabbits. Ten New Zealand rabbits accepted anterior chamber perforation,inset a special irrigating tube, underwent anterior chamber perfusion for 2 hours. Left eyes received lactated Ringer solution, right eyes received BSS. Measured central thickness with a corneal pachymetry every 10 min during the perfusion. Following the perfusion, the corneas were fixed for scanning electron microscopical(SEM) and transmission electron microscopical(TEM) observations of endothelial changes. The differences between swelling rate and resultant thickness of the two groups were significant. Corneas perfused with BSS swelled at a rate of 0.423?3 μm/min while corneas perfused with lactated Ringer solution swelled at a rate of 0.742?6 μm/min. It was statistically significant. Viewed with SEM and TEM, endothelial cells perfused with BSS showed milder degenerative changes; cells lightly swelled and comparatively maintained their basic shapes. By contrast,endothelial cells perfused with lactated Ringer solution showed extensive degenerative changes; cells highly swelled and were in various states of disruption. The conclusion is that commerical balanced salt solution is a comparatively better intraocular irrigating solution.