Green K, Chapman J, Cheeks L
Department of Ophthalmology, Medical College of Georgia, Augusta 30912-3400.
Lens Eye Toxic Res. 1992;9(3-4):439-46.
The subconjunctival injection of commercial gentamicin, given either as a single dose or as repeated injections, caused a hyperemic conjunctival response. Simultaneously there was a toxic myopathy induced in the extraocular muscles. The overall response, followed with light microscopy, occurred as a focal infiltrate of polymorphonuclear leukocytes with progression over a few days to a mononuclear cell infiltrate that accompanied fiber degeneration. Injections of each ingredient of commercial gentamicin individually showed that only gentamicin caused the muscle response; methylparaben, EDTA, and sodium bisulfite were without effect. The pH of the solution was eliminated as a contributing factor as was osmolarity of the injection. Increasing recognition is being given to post-operative complications caused by the prophylactic subconjunctival injection of gentamicin following cataract, and other intraocular surgery. The present data offer a mechanistic explanation for many of these toxic findings.
结膜下注射市售庆大霉素，无论是单次注射还是重复注射，都会引起结膜充血反应。同时，眼外肌会诱发中毒性肌病。通过光学显微镜观察，整体反应表现为多形核白细胞的局灶性浸润，几天内进展为伴有纤维变性的单核细胞浸润。分别注射市售庆大霉素的每种成分表明，只有庆大霉素会引起肌肉反应；对羟基苯甲酸甲酯、乙二胺四乙酸和亚硫酸氢钠均无作用。溶液的pH值和注射的渗透压均被排除为促成因素。白内障及其他眼内手术后预防性结膜下注射庆大霉素所引起的术后并发症越来越受到关注。目前的数据为许多这些毒性发现提供了一个机制性解释。
