Meng Zi-Jun, Zhu Lei
Henan Institute of Ophthalmology, Zhengzhou 450003, China.
Zhonghua Yan Ke Za Zhi. 2004 Nov;40(11):760-4.
To investigate the histologic and physiologic changes in rabbit retina damaged by infusion air and to explore the mechanism of vision defects after vitreoretinal surgery.
Twenty four pigmented rabbits were randomly divided into three groups of eight each, a standard three port vitrectomy followed by fluid-air exchange was performed in 16 eyes, humidified air was infused with an air pressure of 25 or 40 mm Hg and then the vitreous cavity was refilled with balanced salt solution. As a control, vitrectomy without fluid-air exchange was performed in the remaining eight eyes. Clinical examinations and electroretinography were performed before and after the operation. Six weeks after the operation, the rabbits were sacrificed, their eyes were enucleated and examined by light and electron microscopy.
One day postoperatively, the value of bA ratio of group A and group B decreased significantly. Six weeks later, the physiologic function of eyes in group A seemed to have a tendency to recover while that of group B not. With light microscopy, the retina opposite the infusion location in eyes of group B was disorganized, with loss of some layers of sensory retina, and the thickness of total retina and the outer layer of the retina was sharply reduced, the changes in the latter appeared more prominently. With electron microscopy, marked lesions were observed in the nerve fiber layer and photoreceptor cells in eyes of group B, the pathologic changes in group A were slighter than that of group B. In contrast, no morphologic change was present in the control eyes.
Irreversible changes were produced in rabbit retina by air infusion during vitrectomy. The damages are more serious in the eyes perfused with higher air pressure. Air infusion during vitrectomy may be one of the main factors producing vision defects.
研究空气注入对兔视网膜造成的组织学和生理学变化,探讨玻璃体视网膜手术后视力缺陷的机制。
将24只色素兔随机分为3组,每组8只。对16只眼行标准三通道玻璃体切除术,随后进行液气交换,以25或40mmHg的气压注入湿润空气,然后用平衡盐溶液重新填充玻璃体腔。作为对照,对其余8只眼行不进行液气交换的玻璃体切除术。在手术前后进行临床检查和视网膜电图检查。术后6周,处死兔子,摘除眼球,进行光镜和电镜检查。
术后1天,A组和B组的bA比值显著降低。6周后,A组眼的生理功能似乎有恢复趋势,而B组则没有。光镜下,B组眼注入部位相对的视网膜结构紊乱,感觉视网膜某些层缺失,视网膜总厚度和视网膜外层厚度急剧减少,后者变化更明显。电镜下,B组眼的神经纤维层和光感受器细胞有明显病变,A组的病理变化比B组轻。相比之下,对照眼无形态学改变。
玻璃体切除术中空气注入可使兔视网膜产生不可逆变化。气压较高的眼中损伤更严重。玻璃体切除术中空气注入可能是导致视力缺陷的主要因素之一。