离体猪眼前囊膜经次氯酸钠化学处理后的生物力学变化  

Biomechanical changes of isolated porcine anterior capsular membrane after chemical processing with sodium hypochlorite

作　　者：裴雅婧 韩少峰 卢铭锋 杨洋[3] 马科 Pei Yajing;Han Shaofeng;Lu Mingfeng;Yang Yang;Ma Ke(Beijing Institute of Ophthalmology,Beijing Tongren Eye Center,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;School of Energy Power and Mechanical Engineering,North China Electric Power University,Beijing 102206,China;School of Mechanical Engineering and Automation,Beihang University,Beijing 100191,China)

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科研究所眼科学与视觉科学北京市重点实验室,100730 [2]华北电力大学能源动力与机械工程学院,北京102206 [3]北京航空航天大学机械工程及自动化学院,100191

出　　处：《眼科》2022年第3期219-224,共6页Ophthalmology in China

基　　金：国家重点研发计划(2017YFB1302705)。

摘　　要：目的研究离体猪眼前囊膜经次氯酸钠化学处理后的生物力学参数的变化,为白内障手术初学者和眼科手术机器人的撕囊训练提供更接近于人眼的训练材料。设计实验研究。研究对象新鲜离体猪眼48只、眼库正常人眼晶状体8个。方法将猪眼随机分为4组,每组12眼,A组为未处理组,0.1%、0.3%、0.5%次氯酸钠溶液处理前囊膜者分别为B、C、D组。8个人眼晶状体为E组。B、C、D组分别在前囊膜表面滴0.1%、0.3%、0.5%次氯酸钠溶液5分钟。一位操作熟练的白内障专科医师使用微力感知撕囊镊对5组晶状体进行连续环形撕囊并对撕囊手感进行问卷评价,通过光纤光栅解调仪实时记录撕囊时的生物力学数据,包括最大撕囊力和平均撕囊力。主要指标撕囊手感评价问卷评分;最大撕囊力和平均撕囊力。结果医师对猪眼晶状体刺囊及撕囊手感的评分,A组平均分数为(4±0)分,B、C、D组的平均分数均为(3±0)分。最大撕囊力A~E组分别为(34.53±6.02)mN、(29.49±7.00)mN、(28.94±4.71)mN、(26.14±2.39)mN、(24.06±8.18)mN(H=15.07,P=0.005);平均撕囊力分别为(15.58±3.04)mN、(13.48±4.05)mN、(12.67±2.59)mN、(11.40±1.65)mN、(10.98±4.33)mN(H=13.79,P=0.008)。A组与D组在最大撕囊力(Z=19.33,P=0.037)、平均撕囊力(Z=20.33,P=0.023)上均存在显著性差异;A组与E组在最大撕囊力(Z=26.58,P=0.004)与平均撕囊力(Z=24.04,P=0.012)上存在显著性差异;其余各组之间最大撕囊力与平均撕囊力无显著性差异。结论使用0.5%次氯酸钠溶液处理的新鲜离体猪眼晶状体前囊膜的撕囊力最接近于人晶状体前囊膜的撕囊力,处理后的猪眼晶状体前囊膜可用于白内障手术初学者和眼科手术机器人的撕囊训练。(眼科,2022,31:219-224)Objective To study the changes of biomechanical parameters of isolated porcine anterior capsular membrane after chemical treatment with sodium hypochlorite.Design Experimental study.Participants 48 porcine eyeballs and 8 cadaveric eye lenes.Methods Porcine eyeballs were randomly divided into four groups(12 eyes each group):group A(untreated group),group B,C and D(treated with 0.1%,0.3%and 0.5%sodium hypochlorite respectively in the anterior capsule).Eight cadaveric eyes lens were marked as group E.In B,C and D group,the anterior capsular surface was placed horizontally upward.No special treatment was performed in group A.In groups B,C and D,0.1%,0.3%and 0.5%sodium hypochlorite were dripped on the surface of anterior capsule for 5 minutes.Cataract expert used micro-force-sensing capsulorhexis forceps to perform continuous circular capsulorhexis on five groups of lenses,evaluated the feel of capsulorhexis by the questionnaire and recorded the biomechanical data of capsulorhexis in real time by the interrogator.Main Outcome Measures Score of the evaluation questionnaire on the hand feeling of capsulorhexis;biomechanical indexes include maximum capsulorhexis force and average capsulorhexis force.Results According to the doctor's score on the feel of piercing and tearing the lens of porcine,the average score of group A was 4±0,and the average score of groups B,C and D was 3±0 respectively.The maximum tear force in group A to E was 34.53±6.02 mN,29.49±7.00 mN,28.94±4.71 mN,26.14±2.39 mN,24.06±8.18 mN,respectively(H=15.07,P=0.005).The average tear force was 15.58±3.04 mN,13.48±4.05 mN,12.67±2.59 mN,11.40±1.65 mN,10.98±4.33 mN,respectively(H=13.79,P=0.008).There were significant differences between group A and D,in the maximum(Z=19.33,P=0.037)and average tear force(Z=20.33,P=0.023);there were significant differences between group A and E in the maximum(Z=26.58,P=0.004)and average tear force(Z=24.04,P=0.012),but there were no significant differences between the other groups.Conclusion The capsulorhexis force o

关 键 词：晶状体前囊 连续环形撕囊 动物模型 

分 类 号：R779.66[医药卫生—眼科] R-332[医药卫生—临床医学]