t-PA抑制白内障术后眼内纤维膜形成的实验研究

The inhibition on the formation of intraocular fibrinous membrane after cataract extraction by tissue plasminogen activator

研究白内障手术后注射 t- PA抑制眼内纤维蛋白渗出及眼内纤维膜的形成。方法 :成年青紫兰兔行晶体囊外摘除 ,部分后房型人工晶体植入 ,术后不同时间、不同浓度结膜下注射 t- PA,分别于 1、 3、 7、 14、3 0天摘除眼球 ,病理常规切片 ,光镜观察。结果 :注射 t- PA后 ,眼内发生显著的病理形态变化 ,主要有四方面改变 :减轻前房纤维蛋白及炎症细胞的渗出 ;减少虹膜、睫状体细胞的增生抑制眼内纤维膜的形成 ;减弱晶体囊膜增厚及皱褶的程度。结论 :t- PA具有显著的抑制纤维蛋白渗出及眼内纤维膜形成的作用 ,不同浓度 t- PA均有相同作用 ,以术后第 7天效果明显。 t- PA是治疗后发性白内障的安全、有效药物。

Objective: To investigate the inhibition effects of tissue plasminogen activation (t-PA) on the formation of intraocular fibrinous membrane after cataract surgery. Methods: The surgery of extracapsular lens extraction was run on all the adult pigmented rabbits. Some rabbits were undergone the PC-IOL implantation. The rabbits received the sub-conjunctival injection with different concentrations of t-PA at different times after operations. At the day of 1, 3, 7, 14 and 30 after the injection, the eyes were extracted and observed with light microscopy. Results: The evident intraocular histological changes after the injection of t-PA were found as follows: 1. Fibrinous and inflammatory cells exudation weakened. 2. Decreased hyperplasia of cells in the iris and ciliary body. 3. Intraocular fibrinous membrane formation prohibited. 4. Inhibited thickening and folding of the lens capsular membrane. Conclusions: t-PA was very effective to prohibit the fibrinous exudation and the intraocular fibrinous membrane formation. The effects were most significant at the 7th day after the injection of t-PA.