地塞米松注射液联合葡萄糖高渗液对兔眼角膜内皮的保护作用

Protective effect of Dexamethasone combined with hypertonic solution on corneal endothelium in rabbit eyes

目的:探讨地塞米松联合葡萄糖高渗液对兔眼角膜内皮的保护作用。方法:健康日本大耳白兔20只40眼按随机数字表法分为A、B、C、D四组,各组均予以平衡盐溶液与灭菌注射用水按3∶7配成的低渗液维持前房灌注10min建立角膜水肿动物模型,A组造模后立即予以地塞米松注射液0.2mL结膜下注射、高渗葡萄糖液点眼,B组造模后立即予以0.9%生理盐水0.2mL结膜下注射、平衡盐溶液点眼,C组造模后第2d予以地塞米松注射液0.2mL结膜下注射、高渗葡萄糖液点眼,D组造模后第2d予以0.9%生理盐水0.2mL结膜下注射、平衡盐溶液点眼。造模后第1、3、5、7d在裂隙灯下观察兔眼角膜水肿情况,角膜内皮仪测量角膜内皮细胞计数,前节OCT检查角膜,并用A超测量角膜中央厚度。结果:A组兔眼在整个实验观察期间角膜无水肿或仅轻度水肿,角膜中央厚度几乎未增加,角膜内皮细胞数无明显变化,与造模前相比均无明显差异(P>0.05);B、C、D组兔眼造模后角膜均出现不同程度水肿,角膜厚度增加,与A组比较有明显差异(P<0.05),且B、D组兔眼由于角膜水肿在观察期间无法测出角膜内皮细胞数,C组至造模后第7d可测出角膜内皮细胞数,但较造模前及A组造模后第7d角膜内皮细胞数均明显减少(P<0.05)。结论:地塞米松注射液联合葡萄糖高渗液对兔眼角膜内皮细胞有良好的保护作用,早期联合应用能有效预防及治疗角膜水肿,避免进展至角膜内皮失代偿。

AIM:To explore the protective effect of dexamethasone combined with hypertonic solution on corneal endothelial cells of rabbit eyes.METHODS:We made four groups of rabbits for different treatments with dexamethasone and hypertonic solution.All groups were treated with low-permeability solution for 10min to maintain anterior chamber perfusion.Group A was treated with 0.2mL dexamethasone subconjunctival injection,and hypertonic glucose eye drop immediately after surgery.Group B(control group)was subjected to 0.2mL of 0.9%saline subconjunctival injection,and balanced salt solution eye drop immediately after surgery.In group C,0.2mL dexamethasone subconjunctival injection,and hypertonic glucose eye drop were given on the second day of surgery and in group D(control group),0.2mL of 0.9%saline through subconjunctival injection and balanced salt solution eye drop were given on the second day of the surgery.The edema degree of cornea was observed with slit lamp before the operation and on the 1,3,5 and 7d after operation.The cornea were also examined by anterior segment OCT,and the corneal thickness was measured by A-scan ultrasonography.RESULTS:In group A,during the entire experimental observation period,the cornea had no edema or only mild edema,the thickness of the central cornea hardly increased,and the number of corneal endothelial cells did not change significantly.There was no significant difference compared with(control group B)before modeling(P>0.05).In groups B,C,and D,corneal edema and corneal thickness increased after the rabbit eyes were modeled.There was a significant difference compared with group A(P<0.05).The number of corneal endothelial cells in the rabbit eyes of groups B and D could not be measured during the observation period due to corneal edema.The number of corneal endothelial cells can be measured in group C up to the 7d after modeling.The number of corneal endothelial cells in group C was significantly reduced as compared with group A(P<0.05),which before modeling and the 7d after modeling.CONCLUSION:Dexamethasone combined with hypertonic glucose solution has a good protective effect on rabbit corneal endothelial cells.And early application can effectively prevent rabbit corneal edema and this method can also prevent the progression of corneal endothelial decompensation.