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尸体眼球经微脉冲和连续波经巩膜光凝术后的组织病理学变化。

Histopathologic changes in cadaver eyes after MicroPulse and continuous wave transscleral cyclophotocoagulation.

机构信息

University of Southern California Roski Eye Institute, Los Angeles, CA.

Department of Pathology, Yale University School of Medicine, New Haven, CT.

出版信息

Can J Ophthalmol. 2020 Aug;55(4):330-335. doi: 10.1016/j.jcjo.2020.03.010. Epub 2020 May 21.

Abstract

OBJECTIVE

The purpose of this study was to compare the acute histological effects of MicroPulse transscleral cyclophotocoagulation (MPCPC) using the MicroPulse P3 Device and continuous wave transscleral cyclophotocoagulation (CWCPC) on the ciliary body and adjacent structures in human cadaver eyes.

METHODS

Quadrants of 6 human cadaver eyes from 3 different donors were subjected to traditional CWCPC, slow burn CWCPC, MPCPC, or no treatment (internal control). Sutures were used to differentiate different treatment areas on each eye. Differential inking was applied after treatments to aid in microscopic correlation. All specimens were subject to standard histologic processing. Tissue sections were cut at 4 microns and stained with hematoxylin and eosin according to established protocols. Pathologic evaluation by light microscopy was confirmed by a senior pathologist blinded to treatment groups.

RESULTS

In all 6 eyes, tissues treated with traditional and low burn CWCPC showed variable coagulative tissue damage to the ciliary body compared with untreated tissues. Minimal histologic changes were identified within the ciliary processes, although variable pigment clumping and streaming were noted within the pigmented ciliary epithelium. In contrast to CWCPC, MPCPC-treated tissues showed only minimal coagulative tissue damage to the ciliary body. Variable pigment clumping and streaming, however, were also noted in the pigmented ciliary epithelium in MPCPC-treated tissues.

CONCLUSIONS

In human cadaver eyes, MPCPC treatment caused less tissue disruption to the ciliary body compared with traditional and low burn CWCPC treatments. MPCPC may be a less destructive and more selective method of cyclophotocoagulation when compared with traditional and low burn CWCPC.

摘要

目的

本研究旨在比较使用 MicroPulse P3 设备的微脉冲经巩膜睫状体光凝术(MPCPC)与传统连续波经巩膜睫状体光凝术(CWCPC)对人尸体眼球睫状体和邻近结构的急性组织学影响。

方法

来自 3 名不同供体的 6 只人尸体眼球的象限分别接受传统 CWCPC、慢燃 CWCPC、MPCPC 或未治疗(内部对照)。在每只眼睛上使用缝线来区分不同的治疗区域。治疗后应用差异染色以帮助显微镜相关。所有标本均进行标准组织学处理。组织切片以 4 微米切割,并根据既定方案用苏木精和曙红染色。通过对治疗组不知情的资深病理学家进行光镜下病理评估来确认组织学评估。

结果

在所有 6 只眼中,与未治疗组织相比,接受传统和低燃 CWCPC 治疗的组织显示出睫状体的可变凝固性组织损伤。睫状突内仅识别出最小的组织学变化,尽管在色素性睫状上皮内观察到可变的色素团块和流注。与 CWCPC 相反,MPCPC 治疗的组织仅对睫状体造成最小的凝固性组织损伤。然而,在 MPCPC 治疗的组织中,也观察到色素性睫状上皮内的可变色素团块和流注。

结论

在人尸体眼球中,与传统和低燃 CWCPC 治疗相比,MPCPC 治疗对睫状体的组织破坏较小。与传统和低燃 CWCPC 相比,MPCPC 可能是一种破坏性较小且更具选择性的睫状体光凝术方法。

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