Department of Ophthalmology, State Hospital, Rize, Turkey.
Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey.
Cutan Ocul Toxicol. 2020 Dec;39(4):332-340. doi: 10.1080/15569527.2020.1813748. Epub 2020 Sep 9.
We aimed to compare the local effects of intracameral cefuroxime diluted in normal saline (SF groups) against those of cefuroxime in balanced salt solution (BSS group) on the cornea of rabbits.
Fourteen New Zealand albino rabbits were randomised into two groups. The right eyes of the rabbits in the SF group I were injected intracamerally with 1 mg cefuroxime diluted with 0.1 mL normal saline ( = 7), whereas the right eyes of the BSS group II were injected with 1 mg intracameral cefuroxime diluted with 0.1 mL with balance salt solution, and the left eyes of all rabbits received no treatment group III (control group). Corneal thickness was measured with pachymetry before and 1 week after the injection. Corneal samples were evaluated with light, specular and electron microscopy.
Mean endothelial cell count was lower in the SF than in the BSS and control groups. Although an increase in corneal thickness was found in both treatment groups, this was not the case for the control group. The corneal endothelium preserved its hexagonal structure in all groups. Although both treatment groups showed a loss of endothelial microvilli, this was more prevalent in the SF group. However, microvilli were preserved in the control group. Dissolution of tight junctions in corneal endothelium was observed in the SF group only. Mitochondrial swelling, coarsening of endoplasmic reticulum, cytoplasmic vacuolisation, and increased endothelial cell sizes were the same in both treatment groups but was not observed in the control group. Thicker and more oedematous corneal stroma were observed in the SF group compared with the BSS and control groups.
Dilution of intracameral cefuroxime in BSS yielded superior results compared with dilution in normal saline owing to toxicity to the endothelial cells and decline in the endothelial cell number, resulting in intracellular and intercellular morphological changes. BSS or any other solution with proven safety should be used in clinical studies.
本研究旨在比较在生理盐水（SF 组）中稀释的头孢呋辛与在平衡盐溶液（BSS 组）中稀释的头孢呋辛对兔眼角膜的局部作用。
将 14 只新西兰白兔随机分为两组。SF 组 I 的右眼通过注射 0.1ml 生理盐水稀释的 1mg 头孢呋辛（ = 7），BSS 组 II 的右眼通过注射 0.1ml 平衡盐溶液稀释的 1mg 头孢呋辛，所有兔子的左眼均未接受治疗（对照组 III）。注射前和注射后 1 周用角膜测厚仪测量角膜厚度。用光镜、共聚焦显微镜和电子显微镜观察角膜标本。
SF 组的内皮细胞计数低于 BSS 组和对照组。虽然两组治疗组的角膜厚度均有增加，但对照组无此现象。各组角膜内皮均保持六边形结构。虽然两组治疗组均出现内皮微绒毛丢失，但 SF 组更为明显。然而，对照组的微绒毛得以保留。仅在 SF 组观察到角膜内皮紧密连接的溶解。仅在 SF 组观察到线粒体肿胀、内质网增粗、细胞质空泡化和内皮细胞增大。两组治疗组均有上述现象，但对照组无此现象。与 BSS 组和对照组相比，SF 组的角膜基质更厚且更水肿。
与在生理盐水中稀释相比，在 BSS 中稀释头孢呋辛可获得更好的结果，因为这会导致内皮细胞毒性和内皮细胞数量减少，从而导致细胞内和细胞间形态学变化。在临床研究中应使用 BSS 或任何其他已证明安全的溶液。
