兔眼后房型人工晶体植入术后体液免疫的动态观察

Continuous observation for humoral immunity after cataract extraction with the implantation of posterior chamber intraocular lens in rabbit eyes

目的 研究兔眼后房型人工晶体植入 (Posteriorchamberintraocularlens,PC IOL)术后体液免疫反应 (HI)的变化 ,探讨人工晶体与体液免疫反应变化及术后炎症反应的关系。方法 家兔 4 8只 ,随机分为A、B 2组 ,每组 2 4只。A组行右眼透明晶体超声乳化吸除及人工晶体植入 ;B组行右眼透明晶体超声乳化吸除。分别在术前及术后第 7、14、2 1、2 8、35天采血测定IgG、IgM、CH50 、C3、Circulatingimmunecomplex (CIC) ,并观察临床指征———睫状充血、房水浑浊程度的变化。结果 A、B 2组术后IgG、IgM、CIC均升高 ,2组间无显著性差异 (P >0 .0 5 )。CH50 、C3均降低 ,2组间也无显著性差异 (P >0 .0 5 )。A组术后眼内反应明显较B组重 ,差异非常显著 (P <0 .0 1)。结论 人工晶体 (PMMA)具有较好的稳定性 ,眼内植入安全。术后早期眼内炎症主要是由人工晶体异物性刺激及手术机械性损伤引起 。

Objective To study changes of humoral immunity after cataract extraction with the implantation of posterior chamber intraocular lens(PC-IOL)in rabbit eyes, and to investigate the relationship between IOL and changes of HI and the post-operation inflammatory reaction of the eyes. Methods 48 experimental rabbits were equally divided into 2 groups. Group A was treated phacoemulsification and implanted with PC-IOL, group B was treated phacoemulsification only. Before the treatment and on the seventh, fourteenth, twenty-first, twenty-eighth and thirty-fifth days after the operation, serum IgG, IgM, CH 50,C 3,circulating immune complex were determined with polyethylene glycol comparison method, and the degree of aqueous flare and fibrin were evaluated with slit-lamp microscopy.Results After the operation, serum IgG, IgM and CIC increased markedly and complement CH 50, C 3 decreased. There was no statistically significant difference between group A and group B (P>0.05).The post-operation inflammatory reaction of the eye in group A was significantly more serious than that of group B statistically(P<0.01).Conclusion The PMMA IOL is not obviously related with the changes of HI after the operation, and it is safe to implant in the eyes. The early post-operation inflammatory reaction is caused by the foreign body irritation of the IOL and trauma caused by the instruments. HI could well be related to delayed acute uveitis.