Eye Hospital of Wenzhou Medical College, Wen Zhou, China.
Eye (Lond). 2011 Nov;25(11):1499-503. doi: 10.1038/eye.2011.197. Epub 2011 Sep 16.
To investigate the feasibility of bypassing occluded segments of retinal venous main vessels in isolated, arterially perfused caprine eyes via the closed-sky vitrectomy approach using keratoprosthesis.
Isolated caprine eyes were used in this study. For each eye, the retinal vessel was perfused by Krebs solution via ophthalmic artery, and pars plana vitrectomy was performed using temporary keratoprosthesis. All retinal micro-vascular maneuvers were performed in a closed-sky eyeball. The main retinal vein was blocked by endodiathermy at the site of the vessel's first branching. Two openings, several millimeters apart, were created by vascular punctures in both the main vein and its branch vein wall straddling the induced occluded segment. Catheterization was achieved using a flexible polyimide tube, with each end inserted into the vessel wall opening. A sealed connection between the vessel and the tube was obtained by endodiathermy. Bypass of the occluded retinal vein segment was thus achieved, and the patency of this vascular bypass was confirmed by intravascular staining.
Puncturing, catheterization, and endodiathermy were viable by closed-sky approach using keratoprosthesis. Bypassing of the occluded retinal main vein segment was accomplished with the combination of these maneuvers. Good results were obtained in 23 of 38 (60%) caprine eyes.
This study demonstrated that bypassing the occluded segment of retinal main vein can be successfully performed in a closed-sky eyeball model of isolated, arterially perfused caprine eye. This early work indicated that the more advanced retinal vascular bypass surgery in in vivo eye may be feasible in the future.
通过使用角膜假体的闭合天空玻璃体切除术方法，研究在隔离的、动脉灌注的山羊眼通过闭塞的视网膜静脉主干段的可行性。
本研究使用了隔离的山羊眼。对于每只眼，通过眼动脉用 Krebs 溶液灌注视网膜血管，并使用临时角膜假体进行后段玻璃体切除术。所有视网膜微血管操作均在闭合天空眼球内进行。通过在血管第一次分支处对主视网膜静脉进行内电凝来阻塞静脉。在主静脉及其分支静脉壁上跨越诱导的闭塞段，通过血管穿刺创建两个相隔几毫米的开口。通过将柔性聚酰亚胺管的每一端插入血管壁开口来实现导管化。通过内电凝在血管和管之间获得密封连接。从而实现了闭塞的视网膜静脉段的旁路，并且通过血管内染色证实了这种血管旁路的通畅性。
使用角膜假体的闭合天空方法可行用于穿刺、导管化和内电凝。通过这些操作的组合，完成了闭塞的视网膜主静脉段的旁路。在 38 只山羊眼（60%）中的 23 只中获得了良好的结果。
本研究表明，在隔离的、动脉灌注的山羊眼的闭合天空眼球模型中，可以成功地进行闭塞的视网膜主静脉段的旁路。这项早期工作表明，在未来可能可行在体眼中进行更先进的视网膜血管旁路手术。
