LASIK术中瞬时高眼压对视网膜神经节细胞凋亡的影响  

Transient high IOP on apoptosis of retinal ganglion cells during LASIK

作　　者：赵海霞[1] 李晓芳[1] 刘丽君[1] 牛春梅[1] 关文英[1] 

机构地区：[1]内蒙古医学院附属医院眼科,内蒙古自治区呼和浩特市010050

出　　处：《眼科新进展》2009年第7期497-500,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:30660194);内蒙古自治区自然科学基金资助(编号:2008);内蒙古医学院附属医院重大科研项目基金资助(编号:NYFY2007001)~~

摘　　要：目的研究准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术中瞬时高眼压对视网膜神经节细胞(retinal ganglion cells,RGC)凋亡的影响。方法40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、45s和2min组,每组各8只。正常对照组不做处理,实验对照组只进行激光治疗。负压吸引20s、45s和2min组先用负压发生器吸引兔眼角巩膜缘,负压吸引分别持续20s、45s及2min,分别于术后不同时间通过透射电镜和光镜观察RGC凋亡的存在,利用TUNEL法检测RGC的凋亡,并与正常对照组进行比较。结果实验对照组和各负压吸引组之间TUNEL标记的凋亡RGC数进行方差分析,各组间比较凋亡RGC数差异均无统计学意义(P均>0.05)。光镜下负压吸引2min组0d时偶见染色阳性RGC,7d时可见神经节细胞层少量的TUNEL阳性RGC,核内出现棕黄色颗粒。透射电镜下观察负压吸引20s和45s组各时间点视神经和视网膜细胞改变轻微,未见凋亡细胞;2min组术后0d、7d、14d神经纤维和视网膜结构明显异常,未见凋亡细胞,至术后28d时恢复正常。结论LASIK术中常规负压吸引时间越长,视网膜结构损伤改变越明显。Objective To investigate the effects of transient high IOP on apoptosis of retinal ganglion cells （RGC） during LASIK. Methods Forty New Zealand white rabbits were randomly divided into normal control, experimental control, vacuum aspiration 20 seconds, 45 seconds and 2 minutes groups, 8 rabbits in each group. Normal control group was without any treatment. Experimental control groups were only treated by laser. Corneoscleral limbus of rabbits＇ eyes were sucked for different period of times（ 20 seconds ,45 seconds and 2 minutes） by negative pressure generator at different vacuum aspiration groups. The transmission electron microscope and light microscope were used to observe the apoptosis of RGC at postoperative different times. TUNEL staining was used to detect the apoptosis of RGC, and then compared with normal con- trol group. Results With analysis of variance, there was no significant difference with apoptotic RGC number stained with TUNEL among experimental control and vacuum aspiration groups （ all P 〉 0. 05 ）. Just after vacuum aspiration 2 minutes, positively stained RGC were seldom to seen, and a small number of positive RGC were found at ganglion cell layers at 7 days after vacuum aspiration under light microscope. Brown granules were found in nucleus. There were slight changes of optic nerves and retinal cells at different times in vacuum aspiration 20 seconds and 45 seconds groups under transmission electron microscope, and no apoptotic cell was found. Structural abnormalities of nerve fiber and retina were significant at postoperative 0 day,7 days,and 14 days in vacuum aspiration 2 minutes group. No apoptotic cell was found, and the structure returned to normal at postoperative 28 days. Conclusion The longer vacuum aspiration lasts during LASIK, the more obviously retinal structure injury changes.

关 键 词：准分子激光原位角膜磨镶术 负压吸引 视网膜神经节细胞 凋亡 TUNEL染色 

分 类 号：R774[医药卫生—眼科] R779.6[医药卫生—临床医学]