Bogaard Joseph D, Young Jonathon B, Movahedan Asad, Kassem Iris S
Department of Ophthalmology, University of Illinois-Chicago, Chicago, IL, USA.
Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.
Transl Vis Sci Technol. 2018 Jan 9;8(1):5. doi: 10.1167/tvst.8.1.5. eCollection 2019 Jan.
We used the juvenile rabbit as a model for investigating therapeutic interventions for postoperative inflammation and fibrin formation following intraocular lens (IOL) insertion for management of pediatric cataracts.
Twelve 6- to 7-week-old, 600 to 900 g rabbits underwent bilateral clear-cornea lensectomy via irrigation and aspiration with IOL insertion. Following wound closure, enoxaparin 8 mg ( = 6 eyes), preservative-free triamcinolone 0.5 mg ( = 6), 8 mg enoxaparin plus 0.5 mg triamcinolone ( = 6), or balanced salt solution ( = 6) was injected into the anterior chamber. Slit-lamp examinations and optical coherence tomography (OCT) scans were performed postoperatively on days 3 through 7, and 14 to characterize levels of inflammation and fibrin. Using 17 additional rabbits, enzyme-linked immunosorbent assays (ELISAs) with 100 μL of aqueous humor were performed to quantify the amount of fibrinogen and fibrin preoperatively and on postoperative day 3. Immunohistochemistry was performed to confirm the presence of fibrin.
Enoxaparin alone and combined with triamcinolone reduced the amount of fibrin present in the anterior chamber compared to untreated eyes, which corresponded to an increase in OCT signal strength. Despite the clear visual axis shown in clinical images, the combination treatment group had the highest levels of soluble fibrin when assessed by ELISA. Immunohistochemistry confirmed the presence of insoluble fibrin seen clinically.
A combination of enoxaparin and triamcinolone appears to provide the most therapeutic benefit by reducing fibrin formation and postoperative inflammation.
The juvenile rabbit is an excellent model to investigate inflammation and fibrin formation following lensectomy with IOL insertion and possibly any intraocular surgery in children.
我们将幼年兔作为模型，用于研究小儿白内障人工晶状体（IOL）植入术后炎症和纤维蛋白形成的治疗干预措施。
12只6至7周龄、体重600至900克的兔子接受了双侧透明角膜晶状体切除术，通过冲洗吸出法植入IOL。伤口闭合后，将8毫克依诺肝素（=6只眼）、0.5毫克无防腐剂曲安奈德（=6只眼）、8毫克依诺肝素加0.5毫克曲安奈德（=6只眼）或平衡盐溶液（=6只眼）注入前房。术后第3至7天以及第14天进行裂隙灯检查和光学相干断层扫描（OCT），以表征炎症和纤维蛋白水平。使用另外17只兔子，术前及术后第3天采集100微升房水进行酶联免疫吸附测定（ELISA），以定量纤维蛋白原和纤维蛋白的量。进行免疫组织化学以确认纤维蛋白的存在。
与未治疗的眼睛相比，单独使用依诺肝素以及与曲安奈德联合使用均减少了前房中纤维蛋白的量，这与OCT信号强度增加相对应。尽管临床图像显示视轴清晰，但通过ELISA评估时，联合治疗组的可溶性纤维蛋白水平最高。免疫组织化学证实了临床上可见的不溶性纤维蛋白的存在。
依诺肝素和曲安奈德联合使用似乎通过减少纤维蛋白形成和术后炎症提供了最大的治疗益处。
幼年兔是研究IOL植入晶状体切除术后以及儿童任何眼内手术后炎症和纤维蛋白形成的极佳模型。
