柔红霉素对兔晶状体上皮细胞及眼前节组织的影响

Study of the effect of daunomycin on rabbit lens epithelial cells and the anterior segment of the eye

目的 :观察柔红霉素对兔晶状体上皮细胞和眼前节组织的影响。方法 :2 0只家兔随机分为两组 ,分别行EC CE +IOL植入术。实验组截囊前于前囊下注入 8μg/ml柔红霉素 0 .2ml,对照组用同量乳酸林格氏液 ,作用 5min。术后观察眼前节变化及眼压。于术后第 7、第 14、第 2 8天共处死18只家兔 ,行后囊膜、角膜、虹膜、睫状体行光学显微镜观察。两组各有 1只家兔于术后第 2 8天处死 ,行后囊膜透射电镜观察。结果 :①光镜下 ,对照组术后各组后囊晶状体上皮细胞增殖 ,数量较多。实验组术后 7天时其与对照组相同。第 14天 ,实验组后囊可见细胞增生 ,细胞核退变 ,细胞密度明显降低。 2 8天时细胞退变 ,密度进一步降低。②电镜下 ,对照组细胞结构完整。实验组细胞变形 ,内部结构不清 ,核质溶解。③两组眼前段组织显示一般手术反应 ,其严重程度、持续时间相同。裂隙灯下术后第 2 8天后囊膜混浊实验组明显轻于对照组。结论 :8μg/ml柔红霉素于截囊前注入晶状体前囊下 ,作用 5min ,可破坏残留的晶状体上皮细胞的微结构 ,短期内抑制家兔晶状体后囊上皮细胞增殖 ,减轻后囊混浊。同期内未观察到对正常眼组织的毒副作用。该药作为抑制晶状体上皮细胞增殖临床用药 。

Objective:To evaluate the effect of daunomycin on lens epithelial cells and anterior eye segment tissue in rabbits.Methods:20 rabbits were randomly assigned to two groups,the control group and the experimental group,for ECCE(extra capsular cataract extraction) +IOL(intraocular lens) surgery. Before the lens capsule were truncated,0.2 ml of daunomycin(8 μg/ml) was injected into the anterior capsule in the experimental group;while the same volume of lactic acid Ringer's solution was used in the control group. The surgery was finished as usual after waiting 5 minutes to let the solution permeate the ambitus. Postoperative reaction in the anterior eye segment tissue and the intraocular pressure(IOP) were carefully observed. 18 rabbits were sacrificed 7,14 and 28 days after surgery and the posterior capsule,the cornea,iris and ciliary body were examined with light microscopy. 2 rabbits were sacrificed 28 d after surgery and the posterior capsule was examined with transmission electron microscopy(TEM).Results:More fibrosis and vacuolated cell proliferation of the lens epithelial cells could be observed 7 d,14 d and 28 d after surgery in the control group. While in the experimental group,7 d postoperatively the situation was similar to that of the control group,14 d postoperatively rarefaction fibrosis and vacuolated cell proliferation could be observed in the posterior capsule,and nuclei degeneration showed obviously lower cell density;28 d postoperatively nuclear degeneration progressed with low cellular density. Under TEM,the cells in the control group were tightly arrayed with clear cellular boundaries and structure;while in the experimental group,cellular deformity and undefined innocellular structure and nuclear cytoplasmic lysis could be observed. There was no significant difference in the severity and duration of general postoperative reaction in the anterior eye segment tissue between the two groups. 28 d postoperatively,posterior capsule turbidity in the experimental group was obviously milder than for that in the control group. There was no significant difference in postoperative IOP change.Conclusion:With an injection of daunomycin(8 μg/ml) into the anterior capsule(and then waiting 5 minutes before truncating the lens capsule),the proliferation of lens epithelial cells could be inhibited and the posterior capsule turbidity was reduced by destroying the microstructure of the lens epithelial cells in rabbits. Meanwhile,no side effects have been observed. Our study showed that daunomycin can be widely used as a drug for inhibiting proliferation of lens epithelial cells in clinical practice.