Kim Kyeong Hwan, Ko Ah Young, Ryu Jin Suk, Kim Mee Kum, Wee Won Ryang
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2013 Aug;27(4):282-7. doi: 10.3341/kjo.2013.27.4.282. Epub 2013 Jul 4.
Recently, conjunctivochalasis repair surgery using electrocauterization has been gaining popularity. However, patients with electrocauterized conjunctivoplasty tend to complain of more postoperative pain than patients undergoing simple excision with suturing. Therefore, we investigated the effects of electrocauterization on inflammation of the conjunctiva using an experimental animal model and compared these with the effects of simple excision with suturing.
Ten New Zealand white rabbits underwent cauterization in the right eyes and excision and suturing in the left eyes. For each eye, we excised or electrocauterized the inferior bulbar conjunctiva, 1 mm in width and 6 mm in length, 2 mm from the limbus. A fine-needle electrode was inserted subconjunctivally, and electrocauterization was performed. In the contralateral eye, the corresponding area was excised and re-approximated with 10-0 nylon sutures. Sutures were removed after 14 days. Tissue samples were obtained at 21 days post-procedure, and inflammatory cells were counted in five randomly selected fields (×200) on hematoxylin-eosin stained slides. Tumor necrosis factor (TNF)-α and interleukin (IL)-1β concentrations in tears were measured using enzyme linked immunosorbent assays.
All cauterized eyes demonstrated smooth surface healing without scarring after 5 days, whereas sutured eyes presented with mild edema with some scarring until the suture was removed. The number of inflammatory cells was significantly greater in sutured eyes compared with cauterized eyes (p = 0.035, Mann-Whitney U-test) at 21 days post-procedure. Tear TNF-α and IL-1β concentrations at 21 days were similar in both groups.
Electrocauterization for conjunctivoplasty seems to be advantageous in terms of inflammation compared with simple suturing and excision.
最近，使用电烙术进行结膜松弛修复手术越来越受欢迎。然而，接受电烙结膜成形术的患者术后疼痛往往比接受简单切除缝合术的患者更多。因此，我们使用实验动物模型研究了电烙术对结膜炎症的影响，并将其与简单切除缝合术的效果进行了比较。
10只新西兰白兔右眼进行电烙术，左眼进行切除缝合术。对于每只眼睛，我们在距角膜缘2mm处切除或电烙宽度为1mm、长度为6mm的球结膜下穹窿部。将细针电极结膜下插入并进行电烙术。在对侧眼，切除相应区域并用10-0尼龙缝线重新缝合。14天后拆除缝线。术后21天获取组织样本，在苏木精-伊红染色玻片上随机选择五个视野（×200）计数炎性细胞。使用酶联免疫吸附测定法测量泪液中肿瘤坏死因子（TNF）-α和白细胞介素（IL）-1β的浓度。
所有电烙术的眼睛在5天后表面愈合良好，无瘢痕形成，而缝合的眼睛在缝线拆除前出现轻度水肿并伴有一些瘢痕形成。术后21天，缝合眼的炎性细胞数量显著多于电烙术的眼睛（p = 0.035，Mann-Whitney U检验）。两组术后21天泪液中TNF-α和IL-1β的浓度相似。
与简单的缝合和切除相比，结膜成形术的电烙术在炎症方面似乎具有优势。
