LASIK术中瞬时高眼压对视网膜超微结构影响的实验研究  

Influence of transient high IOP during LASIK on retinal ultrastructure

作　　者：赵海霞[1] 黄一飞[2] 陆蓓[3] 李晓芳[1] 艾育德[1] 李晓玲[1] 秦丽茹[1] 

机构地区：[1]内蒙古医学院附属医院眼科,呼和浩特010050 [2]中国人民解放军总医院眼科,北京100853 [3]汕头大学香港中文大学联合国际眼科中心,515041

出　　处：《眼科研究》2007年第10期725-728,共4页Chinese Ophthalmic Research

基　　金：国家自然科学基金资助(30660194)

摘　　要：目的探讨LASIK术中瞬时高眼压对兔视网膜超微结构的影响。方法32只健康新西兰大耳白兔随机分为正常对照组、实验对照组、负压吸引20s组和3min组。实验组于术后即刻,术后7d、4周和8周,在光镜和电镜下观察兔眼视网膜组织结构的变化。结果实验对照组与正常对照组相比,视神经和视网膜结构无改变。负压吸引20s组各时间点视神经和视网膜细胞改变轻微;3min组术后即刻至14d神经纤维和视网膜结构明显异常,至术后28d恢复正常。结论LASIK术中负压吸引致眼压急剧升高,可能会导致视网膜亚细胞结构的改变,但这种改变为可逆的,负压吸引持续时间越长改变越明显。Objective Laser in situ keratomileusis（LASIK） is known as a safe operation. But eye doctor all the times concerns the safety of this operation especially the transient high lOP during LASIK. This paper was to study the effect of transient high intraoclular pressure （lOP） caused by negative suction during LASIK on rabbit retinal structure. Methods Thirty-two New Zealand white rabbits were randomly divided into normal control, experimental control, negative suction 20 seconds and negative suction 3 minutes groups. Experimental control groups were treated only using eximer laser. Rabbit eyes were suctioned for different duration （20 seconds,3 minutes） during the LASIK by negative pressure generator in different groups. They were examined with electron and light microscope. Results There was no obvious change in the tissues of optic nerve and retina in normal control and experimental control. After the negative suction for 20 seconds, there was no evident change in optic nerve and retinal cells at various observation times. The edema of optic nerve fibers and retinal cells was seen after postoperative instant to 14th days in the negative suction for 3 min group. These morphology changes recovered until postoperative 28 days. Conclusion Uhrastructural changes of retina and optic nerve may be associated with acute elevated lOP caused by negative suction during LASIK. Over 3 minutes of negative suction alters the retinal uhrastructure.

关 键 词：准分子激光原位角膜磨镶术 眼压 视网膜 超微结构 负压吸引 

分 类 号：R779.63[医药卫生—眼科] R774[医药卫生—临床医学]