Mittra R A, Dev S, Nasir M A, Toth C A
Duke University Eye Center, Durham, NC, USA.
Ophthalmology. 1997 Mar;104(3):558-61. doi: 10.1016/s0161-6420(97)30275-9.
The authors studied the effect of a direct acting antithrombin agent, desulfatohirudin variant 1 (Revasc, Ciba-Geigy, Ltd., Basel, Switzerland), on postoperative fibrin formation after cataract surgery in rabbits.
Phacoemulsification was performed in a masked fashion on 28 eyes of 28 New Zealand white rabbits. Ten control group eyes had lactated Ringer's solution in the infusion and an intracameral injection (approximately 1.5 ml) at the end of the case. Ten group 1 eyes received hirudin 100 micrograms/ml in the infusion and intracameral injection. Eight group 2 eyes had 100 micrograms/ml hirudin in the intracameral injection only. Using slit-lamp examination, all eyes were graded for the amount of fibrin and intraocular hemorrhage in a masked fashion on postoperative day 1.
Comparison of the mean postoperative fibrin grade (0-4) in group 1 (mean = 0.3), group 2 (mean = 0.25) and the control group (mean = 3.4) revealed a statistically significant difference between hirudin-treated and control eyes (P = 0.0002 for group 1, P = 0.0005 for group 2). No intraocular hemorrhage was noted in any group.
Recombinant hirudin significantly decreases postoperative fibrin formation in a rabbit cataract extraction model. Intracameral injection of hirudin alone appears to be at least as effective as infusion of hirudin throughout the case. With further study, this agent has potential for use in cataract surgery on patients known to be at high risk for postoperative fibrin formation.
作者研究了一种直接作用的抗凝血酶药物——去硫酸水蛭素变体1（瑞伐沙班，瑞士巴塞尔汽巴 - 嘉基有限公司）对兔白内障手术后纤维蛋白形成的影响。
对28只新西兰白兔的28只眼进行了盲法超声乳化手术。10只对照组眼睛在输液中使用乳酸林格氏液，并在手术结束时进行前房内注射（约1.5毫升）。10只第1组眼睛在输液和前房内注射中使用100微克/毫升的水蛭素。8只第2组眼睛仅在前房内注射100微克/毫升的水蛭素。使用裂隙灯检查，在术后第1天对所有眼睛的纤维蛋白量和眼内出血情况进行盲法分级。
第1组（平均值 = 0.3）、第2组（平均值 = 0.25）和对照组（平均值 = 3.4）术后纤维蛋白平均分级（0 - 4级）的比较显示，水蛭素治疗组和对照组之间存在统计学显著差异（第1组P = 0.0002，第2组P = 0.0005）。任何一组均未观察到眼内出血。
重组水蛭素在兔白内障摘除模型中显著降低术后纤维蛋白形成。仅前房内注射水蛭素似乎至少与术中全程输注水蛭素一样有效。随着进一步研究，这种药物有可能用于已知术后纤维蛋白形成风险高的白内障手术患者。
