Gao Q, Mou S, Ge J, To C-H, Hui Y, Liu A, Wang Z, Long C, Tan J
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Eye (Lond). 2008 Mar;22(3):461-8. doi: 10.1038/sj.eye.6702875. Epub 2007 May 25.
The current vitreous substitutes such as silicone oil, heavy silicone oil, and polymeric gels that are directly injected into vitreous cavity frequently cause severe intraocular complications. There is a very urgent need to find a more suitable artificial vitreous substitute for pars plana vitrectomy (PPV) surgery.
We have devised a novel capsular artificial vitreous using tailor-made silicone rubber elastomer. The novel device was implanted into the vitreous cavity of rabbit after PPV and the eye was examined by ophthalmoscopy, fundus photography, and tonometry during an 8-week treatment period. B-scan ultrasonography, electroretinogram (ERG), and histological studies by light microscopy were also performed at the end of 8 weeks.
The novel artificial vitreous body consists of a thin vitreous-like capsule with a silicone tube-valve system. The capsule can be folded and implanted into vitreous cavity through 1.5 mm incision on sclera. Physiological balanced solution (PBS) was then injected into the capsule and inflated to support retina and control intraocular pressure (IOP) through the tube-valve system subsequently fixed under the conjunctiva. Experiments using rabbits showed that the novel vitreous body could effectively support the retina and apparently induced no significant pathological changes in the eye over 8 weeks.
This approach may provide a new research strategy in the vitreous replacement technology. The novel artificial vitreous body device can effectively support retina, control IOP, and has good biocompatibility. It may be a good alternative to injecting artificial vitreous although its tamponade properties and usefulness still have to be proven in complex vitreoretinal diseases.
目前诸如硅油、重硅油和聚合物凝胶等直接注入玻璃体腔的玻璃体替代物常常引发严重的眼内并发症。迫切需要找到一种更适合用于玻璃体切割术（PPV）的人工玻璃体替代物。
我们设计了一种使用特制硅橡胶弹性体制成的新型囊状人工玻璃体。在PPV术后将该新型装置植入兔眼玻璃体腔，并在为期8周的治疗期间通过检眼镜检查、眼底照相和眼压测量对眼睛进行检查。在8周结束时还进行了B超超声检查、视网膜电图（ERG）以及光学显微镜下的组织学研究。
新型人工玻璃体由一个带有硅管 - 阀门系统的薄玻璃体样囊组成。该囊可以折叠并通过巩膜上1.5毫米的切口植入玻璃体腔。然后将生理平衡溶液（PBS）注入囊中并使其膨胀，以支撑视网膜并通过管 - 阀门系统控制眼压（IOP），随后固定在结膜下。使用兔子的实验表明，新型玻璃体在8周内能够有效支撑视网膜，并且在眼中显然未引起明显的病理变化。
这种方法可能为玻璃体替代技术提供一种新的研究策略。新型人工玻璃体装置能够有效支撑视网膜、控制眼压，并且具有良好的生物相容性。尽管其填塞特性和实用性在复杂的玻璃体视网膜疾病中仍有待证实，但它可能是注入人工玻璃体的一种良好替代物。
