晶体摘除联合前段玻璃体切除对玻璃体三维网状结构影响的实验研究  

Experimental Study of Effects Structure after Lensectomy on Vitreous Triaxiality Mesh with Anterior Vitrectomy

作　　者：杨红[1] 赵燕[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,武汉430030

出　　处：《实用医学进修杂志》2008年第4期213-219,共7页Journal of Practical Training of Medicine

摘　　要：目的：探讨晶体摘除联合前段玻璃体切除术后玻璃体凝胶结构的改变。方法：未成年有色兔28只，随机分为正常对照组（Ⅰ组）8只，单纯晶体抽吸组（Ⅱ组）10只，晶体摘除联合前段玻璃体切除组（Ⅲ组）10只。术后30d、60d将兔眼摘出，检测重力作用下玻璃体伸展度的改变和玻璃体的液化率；采用羟脯氨酸测试法检测玻璃体中胶原纤维的含量；摘除眼球做电镜标本观察玻璃体视网膜界面的超微结构。结果：术后30dⅢ组的玻璃体伸展度为2．078±0．173cm，明显〈Ⅰ组的2．813±0．224cm和Ⅱ组的2．711±0．220cm（P〈0．05）；术后60dⅢ组的玻璃体伸展度为1．81±0．226cm，明显〈Ⅰ组的2．90±0．25cm和Ⅱ组的2．56±0．158am（P〈0．05）；术后30dⅢ组的玻璃体液化率为38．88±5．93％，明显高于Ⅰ组的24．36±2．07％和Ⅱ组的26．33±2．31％（P〈0．05）；术后60dⅢ组的玻璃体液化率为45．37±5．54％，明显高于Ⅰ组的25．36±2．33％和Ⅱ组的26．24±3．44％（P〈0．05）；术后30d和60d，Ⅲ组玻璃体的羟脯氨酸的含量分别为2．411±0．310μg/ml和2．733±0．245μg/ml，明显高于Ⅰ组和Ⅱ组（P〈0．05），且60d的高于30d的（P〈0．05）；电镜扫描发现，Ⅲ组的玻璃体液化明显，玻璃体胶原纤维网状支架塌陷。结论：晶体摘除联合前段玻璃体切除可使玻璃体三维网状结构塌陷，加快玻璃体的液化。在临床上可能使视网膜脱离等并发症提前发生。Objective： To investigate the changes in vitreous gel structure after lensectomy with anterior vitrectomy in rabbit eye. Methods： Twenty - eight chinchilla piamented rabbits were divided into three groups： 16 eyes were untreated control group（ group Ⅰ ） , 20 eyes had lens aspiration （ group Ⅱ ） , 20 eyes had lensectomy with anterior vitrectomy （ group Ⅲ ）. The eyes were enucleated at the postoprative 30th and 60th day. The changes in vitreous gel mass and liquefaction were investigated. Then the L - Hyp method was utilized to research the content of collage in the vitreous. The eyes were preformend by scanning electron microscopy. Results： On the postoperative day 30, the gel length of group Ⅲ （2.078 ±0. 173 cm） and group Ⅰ （2.813 ±0.224 cm） and group Ⅱ （2.711 ±0.220 cm）（P〈0.05）, on the postoperative day 60, the gel length of group Ⅲ （ 1.81 ± 0. 226 cm） respectively shorter than those group Ⅰ （ 2.90 ± 0.25 cm） and group Ⅱ （2.56 ±0. 158 cm） （P 〈0.05） ; on the postoperative day 30, the rate of liquefaction of vitreous in group Ⅲ （38.88 ±5.93% ） , respectively higher than those in group Ⅰ （24.36 ±2.07%） and group Ⅱ （26.33 ± 2.31 cm）（P 〈0.05）, on the postoperative day 60, the rate of liquefaction of vitreous in group Ⅲ （45.37 ± 5.54% ） , respectively higher than those in group Ⅰ （25.36±2.33%） group Ⅱ （26.24±3.44%）（P〈0.05）;on the postoperative day 30 and 60, the content of collage in group Ⅲ were 2. 411±0. 310 ug/ml and 2. 733± 0. 245 ug/ml, both higher than those in group Ⅰ and group Ⅱ （ P 〈 0.05 ） ; The collagen fibrillar network was discovered to be destructed under scanning electron microscopy. Conclusions： The lensectomy with anterior vitrectomy in rabbit eye can promote the liquefaction of vitreous gel. Clinically, it would be ahead of schedule for complication of retinal detachment.

关 键 词：晶体摘除 前段玻璃体切除 玻璃体结构 玻璃体液化 

分 类 号：R779.1[医药卫生—眼科] R779.6[医药卫生—临床医学]