超声乳化术后粘弹剂代谢及不同灌注液影响的实验研究  

Experimental study of viscoelastic substances absorption and the effect of different infusion solution following Phacoemulsification

作　　者：林辉[1] 齐艳华[1] 洪杉 谷静芝[1] 张铁英[1] 高雅[1] 

机构地区：[1]哈尔滨医科大学第二临床医学院眼科,黑龙江哈尔滨150086 [2]黑龙江省眼病医院,黑龙江哈尔滨150000

出　　处：《哈尔滨医科大学学报》2002年第4期293-296,共4页Journal of Harbin Medical University

摘　　要：目的　观察超乳术后 ,小梁网对粘弹剂代谢的时间和途径 ,不同灌注液对角膜内皮细胞的影响。方法　哈白兔 6只 ,双眼行手术 ,一眼注入Viscoat后正常冲洗 ,一眼不冲洗 ,做透射电镜观察小梁网的代谢情况。另取哈白兔 9只 ,分成 3组 ,一组以BSS +为灌注液 ,一组为林格液加 5 %葡萄糖 ,一组为林格液 ,做扫描电镜观察术后角膜内皮细胞情况。结果　小梁网扫描电镜示 :3天时冲洗组小梁网内Viscoat已完全被吸收 ,未冲洗组仍充满Viscoat,至 7天时大部分才被吸收 ;粘弹剂是直接通过小梁网间隙及细胞主动转运两种方式吸收的。角膜内皮透射电镜示 :3天时BSS +液组角膜内皮细胞形态完整 ,加葡萄糖组内皮细胞有少数脱落 ,林格液组内皮细胞脱落较多 ;7天时前两组内皮细胞已基本覆盖 ,林格液组细胞 14天时才基本恢复。结论　多量粘弹剂会加重小梁网代谢负担 ,应尽量吸除 ,如术中需要保留 ,术后最好观察 7天。BSS +液对角膜内皮细胞的保护作用最好 ,林格液加葡萄糖可加强保护作用。虽然一段时间后角膜内皮细胞均可恢复 ,但林格液组的细胞损伤严重 ,抗再次损伤能力差 。Objective To investigate the time and the approach of viscoelastic substance absorption though the trabecular meshwork following the Phacoemulsification and the effect of different infusion solution on corneal endothelium.Methods Both eyes of six rabbits were operated. Viscoat was cleared out in one eye;wasn't in the other. Abserved viscoelastic agent in trabecular meshwork after the surgery by transmission electron microscope.And another nine rabbits were divided into three groups ,one of which were irrigated with BSS, one with Ringer's plus 5% glucose, the third with only Ringer's. The same procedure as above, then abserved corneal endothelium by scan electron microscope.Results Microscope photograph showed: on the 3rd day, viscoat was eliminated in the former group,but the later group eyes full of viscoat; by the 7th day, most of which was eliminated. Viscoelatic agent wasn't only removed from trabecular space, but also was transported actively by trabecular cells.Corneal microscope photograph showed:cells in the BSS group retained intact shape nearly, several cells of the second group fell off, and more cells in the third group losed. By the 7th days, the former two groups almost recovered themselves, but the last one couldn't recover until the 14th day.Conclusion Much more viscoelastic agent will be a burden to trabecular meshwork, so it should be cleaned out. If it is necessary to keep it in the eye, we should abserve the eye pressure for 7 days at least. BSS protects endothelium best, the second solution is better, and the last one is common.So these cells haven't good ability of resisting again-scathe.

关 键 词：超声乳化术 粘弹剂 实验研究 灌注液 小梁网 角膜内皮细胞 白内障 

分 类 号：R776.1[医药卫生—眼科]