猪源纤维蛋白黏合剂封闭视网膜裂孔的实验研究

Experimental study of retinal adhesives with porcine fibrin sealant kit

目的研究猪源纤维蛋白黏合剂封闭视网膜裂孔替代眼内充填物的可行性。设计实验研究。研究对象45只青紫兰兔(45眼)。方法将45只青紫兰兔的右眼行玻璃体切割、视网膜造孔和视网膜下注液,建立孔源性视网膜脱离模型。模型建立1周后,将符合条件的42只兔眼随机分为3组,每组14眼,经玻璃体切割视网膜复位,裂孔周围行激光光凝裂孔。蛋白胶组用纤维蛋白胶(广州倍绣生物技术有限公司)封闭视网膜裂孔后,玻璃体腔应用灌注液充填;气体组玻璃体腔应用30%SF6气体充填;单纯激光光凝裂孔组玻璃体腔单纯灌注液充填。术后1、4周分别行间接检眼镜、眼底照相、眼B超、OCT及组织病理学检查。主要指标视网膜裂孔封闭及视网膜复位情况。结果术后4周,蛋白胶组、气体组、单纯激光光凝裂孔组视网膜复位分别为12/14眼(85.7%)、13/14眼(92.9%)、5/14眼(35.7%),前两者复位率均显著高于单纯激光光凝裂孔组(P=0.009,0.036)。结论在兔眼的实验研究结果显示,国产猪源纤维蛋白黏合剂能够替代眼内充填物起到临时封闭视网膜裂孔的作用。

Objective To study the feasibility of porcine fibrin sealant kit as substitution of intraocular filling for closing the retinal hole. Design Experimental study. Participants 45 Qing-zilan rabbits（45 eyes）. Methods Vitrectomy combined with puncture in retina and injecting balanced salt solution underneath the retina was performed for establishing hegmatogenous retinal detachment model in each eye of 45 Qing-zilan rabbits. Retinal reattachment surgery and laser photocoagulation line around the hole were performed in all groups. Then porcine fibrin sealant kit（Guangzhou Beixiu Corporation） was used to close retinal holes and perfusion fluid was filled in vitreous cavity in the fibrin glue group（14 eyes）, 30% SF6 was filled in vitreous cavity in the gas group（14 eyes）, and single perfusion fluid was filled in vitreous cavity in control group（14 eyes）. Indirect ophthalmoscopy, fundus photography, B ultrasonography, OCT, and histopathologic examinations were preformed at 1week, and 4 weeks postoperatively. Main Outcome Measures Rate of retinal reattachment. Results On the 4th week after reattachment surgery, 12/14 eyes（85.7%） retinal reattached in fibrin glue group, while 13/14 eyes（92.9%） retinal reattached in gas group. There was no significant difference statistically between these two groups（P =1.00）. However, only 5/14 eyes（35.7%） retinal reattached in the control group. Compared with the former two groups, there were significantly statistical differences（P=0.009, 0.036）. Conclusions The result of experiment in rabbits shows that porcine fibrin sealant kit can replace intraocular fillings in closing retinal holes temporarily.