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在存在眼外伤的情况下,视网膜冷冻疗法会促使牵拉性视网膜脱离的形成。

Retinal cryopexy stimulates traction retinal detachment formation in the presence of an ocular wound.

作者信息

Campochiaro P A, Gaskin H C, Vinores S A

机构信息

Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville 22908.

出版信息

Arch Ophthalmol. 1987 Nov;105(11):1567-70. doi: 10.1001/archopht.1987.01060110113043.

Abstract

Pigmented rabbits were treated with retinal cryopexy applied to 180 degrees of the peripheral inferior retina in one eye, and then a 6-mm full-thickness circumferential wound was made in both eyes 3 mm posterior to the superior limbus. The wounds were sutured, and only eyes with minimal vitreous hemorrhage and no retinal breaks were included in the study. Eyes were then examined with indirect ophthalmoscopy on postoperative days 1, 7, 14, 21, and 28. Of eyes that received cryopexy and an ocular wound (n = 13), the retina in three became totally detached between postoperative days 14 and 28; seven eyes had traction retinal detachment first noted on postoperative day 14 that did not become total by postoperative day 28; and two retinas remained attached, but showed folds suggesting the presence of epiretinal membranes. One retina remained attached without folding. In eyes that received only an ocular wound (n = 13), the retina in one showed folds, and in 12 eyes it remained attached with no evidence of epiretinal membrane formation. Retinas treated with cryopexy alone (n = 4) remained attached without folds. On postoperative day 28, the rabbits were killed, and, after fixation, eyes were examined grossly and by light and electron microscopy. Examination confirmed the presence of vitreous and epiretinal cellular membranes in eyes with retinal detachment. These data suggest that in the presence of an ocular wound, retinal cryopexy, which has previously been shown to cause extensive breakdown of the blood-retinal barrier, stimulates the formation of intraocular cellular membranes and traction retinal detachment.

摘要

对有色素的兔子进行治疗,在一只眼睛的周边下视网膜180度范围进行视网膜冷冻治疗,然后在双眼上睑缘后3毫米处制作一个6毫米的全层环形伤口。伤口进行缝合,仅将玻璃体出血最少且无视网膜裂孔的眼睛纳入研究。术后第1、7、14、21和28天用间接检眼镜检查眼睛。在接受冷冻治疗和眼部伤口的眼睛(n = 13)中,有三只眼睛的视网膜在术后第14天至28天之间完全脱离;七只眼睛在术后第14天首次发现有牵拉性视网膜脱离,到术后第28天未完全脱离;两只视网膜保持附着,但出现褶皱,提示存在视网膜前膜。一只视网膜保持附着且无褶皱。在仅接受眼部伤口的眼睛(n = 13)中,一只眼睛的视网膜出现褶皱,12只眼睛的视网膜保持附着,无视网膜前膜形成的迹象。仅接受冷冻治疗的视网膜(n = 4)保持附着且无褶皱。术后第28天,处死兔子,固定后,对眼睛进行大体检查以及光镜和电镜检查。检查证实视网膜脱离的眼睛中存在玻璃体和视网膜前细胞膜。这些数据表明,在存在眼部伤口的情况下,先前已证明会导致血视网膜屏障广泛破坏的视网膜冷冻治疗,会刺激眼内细胞膜的形成和牵拉性视网膜脱离。

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