Ophthalmology Department, Cairo University, Cairo, Egypt.
Ophthalmology Department, Cairo University, Kasr Al-Eini Hospital, Cairo, Egypt.
Cutan Ocul Toxicol. 2022 Sep;41(3):210-214. doi: 10.1080/15569527.2022.2066113. Epub 2022 Jun 29.
To compare the histopathological effects of injecting two concentrations of Bupivacaine (5 mg/ml and 7.5 mg/ml) in the superior rectus muscle of rabbits, and to compare these to conventional extraocular muscle surgery in previous studies.
Eighteen albino rabbits' eyes were used. The superior rectus muscles were injected with Bupivacaine 5 mg/ml (Group B5, 10 eyes) or 7.5 mg/ml (Group B7, 8 eyes). The rabbits were sacrificed and eyes enucleated 6 weeks later for histopathological evaluation. Results were compared to the average of those obtained, by three previous studies, after conventional superior rectus resection in rabbits.
Foreign body reaction was absent in all specimens. Conjunctival and scleral inflammation, perimuscular adhesions, intramuscular fibrosis, conjunctival and scleral oedema and muscle atrophy were higher in group B7, while conjunctival hyperaemia and muscle hypertrophy were higher in group B5 ( > 0.05). On comparison to conventional surgery, conjunctival inflammation and hyperaemia, foreign body reaction, and adhesions were less after bupivacaine injection ( > 0.05 for all except for intensity of conjunctival inflammation in B5 versus conventional surgery). Scleral inflammation was more frequent after bupivacaine injection ( < 0.05). Muscle fibrosis was more frequent in group B7 and conventional surgery than in group B5 ( > 0.05).
Both Bupivacaine concentrations effectively produced the desired muscle hypertrophy and fibrosis, so the lower concentration may be used for muscle strengthening to correct strabismus. Bupivacaine injection, although produced no foreign body reaction, did not significantly lower the development of undesired postoperative adhesions and caused more scleral inflammation.
比较两种浓度的布比卡因(5mg/ml 和 7.5mg/ml)注射到兔眼外直肌的组织病理学效应,并与既往研究中的常规眼外肌手术进行比较。
本研究共使用 18 只白化兔的眼球。将 5mg/ml 布比卡因(B5 组,10 只眼)或 7.5mg/ml 布比卡因(B7 组,8 只眼)注入外直肌。6 周后处死并眼球摘出,进行组织病理学评估。结果与既往 3 项常规兔外直肌切除术研究的平均值进行比较。
所有标本均无异物反应。B7 组的结膜和巩膜炎症、肌周粘连、肌内纤维化、结膜和巩膜水肿及肌肉萎缩更明显,而 B5 组的结膜充血和肌肉肥大更明显( > 0.05)。与常规手术相比,布比卡因注射后结膜炎症和充血、异物反应和粘连减少( > 0.05,除 B5 组结膜炎症强度与常规手术相比外)。布比卡因注射后巩膜炎症更常见( < 0.05)。B7 组和常规手术组的肌肉纤维化比 B5 组更常见( > 0.05)。
两种布比卡因浓度均能有效产生所需的肌肉肥大和纤维化,因此较低浓度可用于增强肌肉以矫正斜视。布比卡因注射虽然没有产生异物反应,但并没有明显降低术后不良粘连的发生,反而引起更多的巩膜炎症。