Kawasaki Shiro, Tasaka Yoshitaka, Suzuki Takashi, Zheng Xiaodong, Shiraishi Atsushi, Uno Toshihiko, Ohashi Yuichi
Departments of Ophthalmology, Ehime University Graduate School of Medicine, Shitsukawa, Toon-City, Ehime, Japan.
Arch Ophthalmol. 2011 Jun;129(6):751-7. doi: 10.1001/archophthalmol.2011.115.
To investigate the influence of elevated intraocular pressure on the posterior chamber-anterior hyaloid membrane (PC-AHM) barrier during cataract operations in ex vivo porcine eyes.
A pressure transducer was connected to porcine eye anterior chambers (ACs). In experiment 1, ACs were perfused for 20 seconds with balanced salt solution containing 1.0-μm fluorescein beads (10 eyes per bottle height: 45, 85, 145, and 285 cm). In experiment 2, 5 ophthalmic viscosurgical devices with different molecular weights and sodium hyaluronate concentrations were infused into the ACs (20 eyes per ophthalmic viscosurgical device). After continuous curvilinear capsulorrhexis, hydrodissection was performed. After both experiments, PC-AHM barrier staining was evaluated through the Miyake-Apple view.
Types of fluorescein staining patterns were classified as AC, zonule of Zinn, AHM, AHM tear, and ruptured capsule. In experiment 1, plateau intraocular pressure and staining type were positively correlated (Spearman rank correlation; r = 0.703, P < .001). In experiment 2, mean peak intraocular pressure was significantly greater in the ruptured capsule-type eyes than in the AC-, zonule of Zinn-, AHM (P < .001), or AHM-tear-(P = .02) type eyes, as well as in the AHM- and AHM-tear-type eyes compared with the AC and zonule of Zinn type eyes (P < .001). Intraocular pressure was significantly higher in eyes infused with ophthalmic viscosurgical devices with a higher molecular weight or sodium hyaluronate concentration (P < .05).
Stress on the PC-AHM barrier increases as intraocular pressure increases. Ophthalmic viscosurgical devices with a higher molecular weight or sodium hyaluronate concentration might induce increased IOP during cataract operations.
To maintain normal PC-AHM barrier function, excessive intraocular pressure should be avoided during cataract operations.
研究在离体猪眼中白内障手术期间眼压升高对后房 - 前玻璃体膜（PC - AHM）屏障的影响。
将压力传感器连接到猪眼的前房（AC）。在实验1中，用含有1.0μm荧光素珠的平衡盐溶液对前房灌注20秒（每瓶高度10只眼：45、85、145和285厘米）。在实验2中，将5种不同分子量和透明质酸钠浓度的眼科粘弹剂注入前房（每种眼科粘弹剂20只眼）。连续环形撕囊后，进行水分离。两个实验后，通过三浦 - 苹果视图评估PC - AHM屏障染色情况。
荧光素染色模式类型分为前房、睫状小带、AHM、AHM撕裂和囊膜破裂。在实验1中，平台眼压与染色类型呈正相关（Spearman等级相关性；r = 0.703，P <.001）。在实验2中，囊膜破裂型眼的平均峰值眼压显著高于前房、睫状小带、AHM型眼（P <.001）或AHM撕裂型眼（P =.02），以及AHM和AHM撕裂型眼与前房和睫状小带型眼相比（P <.001）。注入分子量较高或透明质酸钠浓度较高的眼科粘弹剂的眼中眼压显著更高（P <.05）。
随着眼压升高，PC - AHM屏障上的应力增加。分子量较高或透明质酸钠浓度较高的眼科粘弹剂可能在白内障手术期间导致眼压升高。
为维持正常的PC - AHM屏障功能，白内障手术期间应避免过高的眼压。
