依地酸二钠预防兔后发性白内障的实验研究  

EDTA inhibits the pathogenesis of posterior capsule opacification:experimental study on the rabbit

作　　者：刘建亭[1] 张素华[1] 钱军[1] 刘杰为[1] 江琳[1] 

机构地区：[1]山西省眼科医院白内障科,山西太原030002

出　　处：《眼视光学杂志》2009年第1期5-9,共5页Chinese Journal of Optometry & Ophthalmology

基　　金：山西省卫生厅科技攻关计划项目(200641)

摘　　要：目的研究不同药物浓度的依地酸二钠(ethylene-diaminetetraaceticacid,EDTA)在白内障术中的应用,探讨其预防兔后发性白内障形成的效果及其对角膜的毒性作用。方法30只兔(60眼)随机分为5组,即对照组(BBS组)和4个药物实验组(5、10、15、30mmol/LEDTA组),每组6只兔(12眼),在麻醉下行透明晶状体超声乳化吸除术,术中用不同浓度的EDTA0.2ml进行水分离,并停留2min。于术后第3天和第1、第2、第3、第4、第12周对各组兔眼进行裂隙灯显微镜观察。在术后第3天时行角膜内皮电镜检查。在术后第12周时行晶状体后囊膜病理学检查,并对晶状体后囊膜中央湿重进行比较。结果①术后角膜及前房的炎症反应:术后第3天,对照组及5、10、15mmol/LEDTA实验组炎症反应轻微;而30mmol/LEDTA组炎症反应重,并有纤维素性渗出物。术后第4周,对照组及5、10、15mmol/LEDTA实验组均未见炎症反应,角膜清亮;而30mmol/LEDTA组仅6只眼角膜清亮,仍有4只角膜有持续水肿,色灰,并伴有眼球进行性增大。②后囊膜混浊情况:术后第12周,10、15mmol/LEDTA组的后囊膜混浊的程度较轻,评分后经统计学分析,差异有统计学意义(χ2=32.775,P<0.01)。③后囊膜中央湿重:术后第12周,10、15mmol/LEDTA组明显轻于对照组与5mmol/LEDTA组,差异有统计学意义(F=40.94,P<0.01)。④病理学检查结果:电镜扫描,术后第3天,对照组与5、10、15mmol/LEDTA实验组角膜内皮细胞大小均匀,未见明显病理性损害;30mmol/LEDTA组角膜内皮细胞不规则,微绒毛稀少,可见病理性损害。光镜,术后第12周,光镜下可见各组均有晶状体上皮细胞增生,但以10、15mmol/LEDTA组为轻,仅为单层晶状体上皮细胞增生。结论白内障手术中用10、15mmol/L药物浓度的EDTA进行水分离,可有效预防后发性白内障的形成,并且对角膜无明显毒副作用。Objective To study concentrations of EDTA （ethylenedi capsule opacification of rabbits cornea. Methods Thirty rabbits the inhibitory effects of different c acid） on posterior and evaluate its toxicity on the （60 eyes） were randomly divided into 5 groups of 6 rabbits each （12 eyes in each group）. The groups included one control group （BBS group） and four experimen- tal groups （5, 10, 15 and 30 mmol/L EDTA groups）. 0.2 ml of BBS and 0.2 ml （5, 10, 15 and 30 mmol/L） of EDTA were administered by hydrodissection to the different groups and remained for 2 minutes in the capsular bag. On the 3rd day and on the 1st, 2nd, 3rd, 4th, and 12th week after surgery, the inflammatory levels of the cornea and anterior chamber and the level of posterior capsule opacification were examined and evaluated with a slit lamp microscope; an electron microscope was used to examine the corneal endothelium. On the 12th week after the operation, the histopathology of the posterior capsule membrane was examined, and the wet weights of the central posterior capsules were measured and compared. Results （1）Inflammatory levels of the cornea and anterior chamber： On the 3rd day after surgery, the inflammatory levels of the cornea and anterior chamber in the control group and the 5, 10 and 15 mmol/L EDTA experimental groups were mild.The level was severe in the 30 mmol/L EDTA group. On the 4th week after surgery, except for the 30 mmol/L EDTA group, only 6 corneas were clear and 4 corneas still had edema. （~）On the 12th week after surgery, the level of posterior capsule opacifieation was significantly less in the 10 and 15 mmol/L EDTA groups than in the BBS and 5 mmol/L EDTA groups （P〈0.01）. （3）The average wet weights of the central posterior capsule in the 10 and 15 mmol/L EDTA groups were significantly lighter than that of the BBS and 5 mmol/L EDTA groups （P〈0.01）. （4）Results of histological examina- tion： Scanning electron microscope： On the 3rd day after surgery, the endothelial cells

关 键 词：依地酸二钠 晶体 上皮细胞 后囊膜混浊 

分 类 号：R779.66[医药卫生—眼科] R998.1[医药卫生—临床医学]