晶状体囊膜抛光联合囊袋内注射透明质酸酶预防兔眼后囊膜混浊

Prevention of rabbit posterior capsule opacification: combining intra-lens-bag injection of hyaluronidase with lens epithelium polishing

目的 :探讨晶状体囊袋内注射透明质酸酶联合囊膜抛光是否可预防兔眼后囊膜混浊及其眼内应用的安全性。方法 :将 4 0只兔随机分为 4组 ,每组均进行超声乳化晶状体吸除联合囊袋内人工晶状体植入术 ,分别采用不抛光不用透明质酸酶、抛光不用透明质酸酶、水分离和抛光囊膜时用进口透明质酸酶和用国产透明质酸酶的方法。手术后不同时期进行组织病理学检查。术后 3个月对每组 5只兔眼的后囊膜混浊进行分级 ,并作组织病理学检查。结果 :术后 3个月经秩和检验第 1、2组的后囊膜混浊发生率与第 3、4组相比差异有显著性 ( P<0 .0 5 ) ;第 3组与第 4组、第1组与第 2组之间差异无显著性 ( P>0 .0 5 )。说明透明质酸酶联合抛光可以降低兔眼后囊膜混浊的发生率 ,而且进口与国产透明质酸酶同样有效。术后病理学检查提示抛光用联合囊袋内注射组术后残留的晶状体上皮细胞最少 ,而且该组的 Soemmering环、Elschnig小体和后囊膜上的细胞都比较少 ,出现晚 ,眼内其它组织未受损害。结论 :晶状体囊袋内注射透明质酸酶联合囊膜抛光可以预防兔眼后囊膜混浊的发生 。

Objective:To assess whether hyaluronidase while hydrodissection and polishing significantly reduces posterior capsule opacification without causing ocular toxicity.Methods:Forty eyes of 40 albino rabbits weighing 2.0 to 2.5 kg were divided into 4 groups of 10 eyes each based on the surgical technique and substances applied during surgery. The control group received only balanced salt solution (in group 2, lens capsule were polished while group 1 not). The experimental group, hyaluronidase (group 3 from Sigma, group 4 from Shanghai) dissolved in balanced salt solution was injected into the capsular bag while hydrodissection and polishing during endocapsular phacoemulsification and intraocular lens implantation in rabbit eyes. 1 week, 2 weeks, 1 month, 2 months after surgery,one eye of each group and five eyes of each group 3 months after surgery were observed by light microscopy. Three months after surgery, posterior capsule opacification of 5 rabbits from each group were scored.Results:The experimental group in rabbit eyes had clear capsules and minor posterior capsule opacification. The control group developed more severe posterior capsule opacification. The difference between the two groups was statistically significant(P<0.05).Conclusion:Our results suggest that the application of hyaluronidase while hydrodissection and polishing effectively reduces posterior capsule opacification in rabbit eyes.