Wenzel M, Ygge J
Augenklinik Medizinische Einrichtungen der RWTH, Aachen, Bundesrepublik Deutschland.
Fortschr Ophthalmol. 1991;88(2):132-4.
A heparin-surface-modified PMMA IOL has recently been developed in order to give the IOL a hydrophilic surface and to reduce postoperative inflammatory reactions in the eye. It is known that severe inflammation accompanies a tremendous increase in leucocytes in IOLs. A foreign-body reaction is characterized by the formation of histiocytic giant cells. The topical administration of corticosteroids, or the surface passivation of IOLs, cannot prevent a foreign-body reaction. Specular microscopy was used for in vivo investigation of cellular reaction in IOL surface of heparin-surface-modified lenses versus regular PMMA lenses. The double-masked and randomized study included 53 patients investigated 1 week and 1 month postoperatively. Small, round, and spindle-shaped cells were the cells most frequently observed after 1 week. These cells were identified in all cases. They were found in a higher density on the surface of the control lenses (43 cells/mm2) than on the heparin-surface-modified lenses (25 cells/mm2). Giant cells were found in two patients after 1 week; both of these patients belonged to the control group. Small, round, and spindle-shaped cells were also seen in all patients 1 month postoperatively. Again, they were found in a higher frequency on the control lenses (38 cells/mm2) than on the heparin-surface-modified lenses (13 cells/mm2). Giant cells were found in 18 patients 1 month postoperatively. They were found exclusively on the control lenses; the difference was significant (p less than 0.0001).
最近开发了一种肝素表面改性的聚甲基丙烯酸甲酯人工晶状体，以使人工晶状体具有亲水性表面，并减少眼睛术后的炎症反应。已知严重的炎症伴随着人工晶状体中白细胞的大量增加。异物反应的特征是形成组织细胞巨细胞。局部应用皮质类固醇或人工晶状体的表面钝化并不能预防异物反应。使用镜面显微镜对肝素表面改性晶状体与普通聚甲基丙烯酸甲酯晶状体的人工晶状体表面细胞反应进行体内研究。这项双盲随机研究纳入了53例患者，在术后1周和1个月进行调查。术后1周最常观察到的细胞是小的、圆形和梭形细胞。所有病例均发现了这些细胞。在对照晶状体表面（43个细胞/mm²）发现它们的密度高于肝素表面改性晶状体（25个细胞/mm²）。术后1周在两名患者中发现了巨细胞；这两名患者均属于对照组。术后1个月在所有患者中也观察到了小的、圆形和梭形细胞。同样，在对照晶状体上（38个细胞/mm²）发现它们的频率高于肝素表面改性晶状体（13个细胞/mm²）。术后1个月在18例患者中发现了巨细胞。它们仅在对照晶状体上发现；差异具有统计学意义（p小于0.0001）。
