Li Yanna, Mai Guanghuan, Wang Zhijian, Yu Xinping, Yu Huanyun, Guo Yan, Lin Xiaoming, Deng Daming, Kang Ying
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
Yan Ke Xue Bao. 2003 Mar;19(1):25-32.
To observe the effect of preserving anterior ciliary vessels (ACVs) on anterior segments of rabbit eyes undergoing tenotomy of extraocular muscles.
Thirty-two adult New Zealand white rabbits were divided into four groups. Same procedures were done in both eyes in each group except that left eyes underwent preservation of ACVs. In the first group medial and lateral recti, in the second group, superior and inferior recti, in the third group, medial, lateral and superior or inferior recti and in the fourth group, all four recti, underwent tenotomy. Slit-lamp examination, intraocular pressure (IOP) measurement, total protein and lactic acid quantification in aqueous humor were done in all eyes pre- and post-operatively. By four weeks after operation, the eyes were enucleated for histological examination and electron microscopy. All data were analyzed using SPSS version 10.
In the left eyes of both group 1 and group 2, no inflammatory response was observed. In the left eyes of group 3 and 4, we observed mild inflammatory response with slit-lamp examination, which disappeared in one wk. However, we did not find significant changes in IOP, total protein and lactic acid of aqueous humor, histology and electron microscopic examination in these groups. In the right eyes in group 2, 3 and 4, we observed moderate to severe inflammatory changes, a few even developed anterior segment ischemia, appeared as decreased IOP, increased total protein and lactic acid in aqueous humor, along with pathological and electron-microscopic changes.
Simultaneous tenotomy of three or four recti or two vertical recti on one eye may decrease anterior segment blood flow even lead to ischemia. ACVs preservation may protect the blood circulation in anterior segment. Our study suggests that ACVs preservation in strabismus surgeries especially those involving multi-recti tenotomies may prevent potential anterior segment ischemia.
观察保留睫状前血管（ACV）对接受眼外肌切断术的兔眼前节的影响。
将32只成年新西兰白兔分为四组。每组双眼均进行相同手术，但左眼保留ACV。第一组切断内直肌和外直肌，第二组切断上直肌和下直肌，第三组切断内直肌、外直肌和上直肌或下直肌，第四组切断全部四条直肌。所有眼睛在术前和术后均进行裂隙灯检查、眼压（IOP）测量、房水中总蛋白和乳酸定量分析。术后四周，摘除眼球进行组织学检查和电子显微镜检查。所有数据采用SPSS 10版软件进行分析。
第一组和第二组的左眼均未观察到炎症反应。在第三组和第四组的左眼中，裂隙灯检查观察到轻度炎症反应，一周后消失。然而，这些组在眼压、房水中总蛋白和乳酸、组织学和电子显微镜检查方面未发现明显变化。在第二组、第三组和第四组的右眼中，观察到中度至重度炎症变化，少数甚至发生了前节缺血，表现为眼压降低、房水中总蛋白和乳酸增加，同时伴有病理和电子显微镜改变。
一眼同时切断三条或四条直肌或两条垂直直肌可能会减少前节血流甚至导致缺血。保留ACV可保护前节的血液循环。我们的研究表明，在斜视手术中，尤其是涉及多条直肌切断术的手术中，保留ACV可能预防潜在的前节缺血。
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