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玻璃体内注入硅酮-氟硅酮共聚物油的兔眼组织病理学

Histopathology of rabbit eyes with intravitreous silicone-fluorosilicone copolymer oil.

作者信息

Doi M, Refojo M F

机构信息

Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA.

出版信息

Exp Eye Res. 1994 Dec;59(6):737-46. doi: 10.1006/exer.1994.1160.

Abstract

Silicone-fluorosilicone copolymer oil is characterized by being heavier than water (density, 1.16 g cm-3) and low viscosity (175-185 centistokes) compared with currently used intraocular silicone oils (density, 0.97 g cm-3 and 1000-5000 centistokes). This oil is potentially useful as an operative tool and a tamponade on the inferior retina in complicated retinal detachment. We evaluate the ocular response clinically and histopathologically within 8 weeks in rabbit phakic eyes to the purified silicone-fluorosilicone copolymer oil after vitreous cavity injection, and compared the oil tolerance with purified silicone oil (0.97 g cm-3, 5000 centistokes) and perfluorotetradecahydrophenanthrene for ophthalmic use (Vitreon, 2.03 g cm-3, 8.03 centistokes) which are currently used as operative tools and as internal retinal tamponade agents in retinal detachment surgery. Because of their low viscosity, silicone-fluorosilicone copolymer oil and perfluorotetradecahydrophenanthrene were easier to inject into the eye than silicone oil. Silicone-fluorosilicone copolymer oil and perfluorotetradecahydrophenanthrene occupied the inferior portion in the eye, and silicone oil occupied the superior portion. Fewer discrete oil droplets and weaker vessel attenuation of medullary rays than in the perfluorotetradecahydrophenanthrene-injected eyes were seen in silicone-fluorosilicone-copolymer-oil-injected eyes. Histopathologically, all retinas injected with silicone-fluorosilicone copolymer oil were normal within 4 weeks. The silicone-fluorosilicone copolymer oil dispersion did not induce histopathological changes within 8 weeks. However, thinning or disappearance of the outer plexiform layer was seen in the inferior retina in some silicone-fluorosilicone-copolymer-oil-injected eyes at 6-8 weeks. A similar effect was found in the superior retina of a silicone-oil-injected eye at 8 weeks. More severe changes such as thinning or disappearance of the outerplexiform layer, thinning and disorganization of the photoreceptor layer, and migration of the receptor cell nuclei to the photoreceptor layer were found in the inferior retina of perfluorotetradecahydrophenanthrene-injected eyes after 2 weeks. Intraocular silicone-fluorosilicone copolymer oil tolerance until about 2 months post-injection is similar to silicone oil and better than perfluorotetradecahydrophenanthrene. Silicone-fluorosilicone copolymer oil may be useful intraoperatively and as a temporary vitreous substitute in cases of inferior retinal detachment.

摘要

硅氟硅氧烷共聚物油的特点是比水重(密度为1.16 g/cm³),与目前使用的眼内硅油(密度为0.97 g/cm³,粘度为1000 - 5000厘沲)相比粘度较低(175 - 185厘沲)。这种油作为一种手术工具和用于复杂视网膜脱离时对下方视网膜的填塞物可能是有用的。我们在兔有晶状体眼中,对玻璃体腔注射纯化的硅氟硅氧烷共聚物油后8周内的眼部反应进行了临床和组织病理学评估,并将其对油的耐受性与目前在视网膜脱离手术中用作手术工具和视网膜内填塞剂的纯化硅油(0.97 g/cm³,5000厘沲)以及眼科用全氟十四氢菲(Vitreon,2.03 g/cm³,8.03厘沲)进行了比较。由于其低粘度,硅氟硅氧烷共聚物油和全氟十四氢菲比硅油更容易注入眼内。硅氟硅氧烷共聚物油和全氟十四氢菲占据眼内下方部分,而硅油占据上方部分。与注射全氟十四氢菲的眼睛相比,注射硅氟硅氧烷共聚物油的眼睛中离散的油滴较少,髓射线血管衰减较弱。组织病理学上,所有注射硅氟硅氧烷共聚物油的视网膜在4周内均正常。硅氟硅氧烷共聚物油分散液在8周内未引起组织病理学变化。然而,在6 - 8周时,一些注射硅氟硅氧烷共聚物油的眼睛的下方视网膜可见外丛状层变薄或消失。在8周时,注射硅油的眼睛的上方视网膜也发现了类似的效应。在注射全氟十四氢菲的眼睛的下方视网膜,2周后发现了更严重的变化,如外丛状层变薄或消失、光感受器层变薄和紊乱以及感受器细胞核向光感受器层迁移。注射后约2个月内,眼内硅氟硅氧烷共聚物油的耐受性与硅油相似,且优于全氟十四氢菲。硅氟硅氧烷共聚物油在手术中以及在下方视网膜脱离的情况下作为临时玻璃体替代物可能是有用的。

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