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视网膜移位术治疗黄斑下脉络膜新生血管I:兔眼实验研究

Translocation of the retina for management of subfoveal choroidal neovascularization I: experimental studies in the rabbit eye.

作者信息

Imai K, Loewenstein A, de Juan E

机构信息

The Wilmer Ophthalmological Institute, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.

出版信息

Am J Ophthalmol. 1998 May;125(5):627-34. doi: 10.1016/s0002-9394(98)00023-3.

Abstract

PURPOSE

To report a surgical method for retinal translocation as a potential treatment for eyes with subfoveal choroidal neovascularization.

METHODS

Thirty right eyes of 30 pigmented rabbits were used for this study. The first 15 were used to develop the technique. The complete surgical technique for retinal translocation was performed in the last consecutive 15 rabbits. Intravitreal injection of sulfur hexafluoride was performed to compress and liquefy the vitreous. Two weeks later, we used transscleral subretinal hydrodissection to create a retinal detachment. A scleral resection was then performed near the equator in the superotemporal quadrant. Fundus photographs were taken to record the retinal status before, immediately after, and 1, 3, and 7 days after surgery. Electroretinography was performed in three rabbits 3, 7, and 14 days after retinal translocation. Histologic studies were performed in one rabbit 7 days after retinal translocation.

RESULTS

Our results are based on experiments performed in the last consecutive 15 rabbits. One day after surgery, retinal reattachment was observed in 14 of the 15 animals. The remaining animal developed endophthalmitis. A predictable retinal translocation of about 1,000 microm was achieved. Retinal tears were noted on the retinal folds in four cases after 1 week. Electroretinographic studies showed transient reduction in retinal function. Mild morphologic damage to the outer retinal layers was seen histologically. Retinal detachment or proliferative vitreoretinopathy did not develop in any rabbit in the 14 days of follow-up.

CONCLUSIONS

Limited retinal translocation with repositioning of the central retina was accomplished in rabbits.

摘要

目的

报告一种视网膜移位手术方法,作为治疗黄斑下脉络膜新生血管眼的潜在治疗手段。

方法

30只色素兔的30只右眼用于本研究。前15只用于开发该技术。对最后连续的15只兔进行了完整的视网膜移位手术技术操作。玻璃体内注射六氟化硫以压缩和液化玻璃体。两周后,我们采用经巩膜视网膜下液流分离术造成视网膜脱离。然后在颞上象限赤道附近进行巩膜切除术。拍摄眼底照片以记录手术前、手术后即刻以及术后1天、3天和7天的视网膜状态。在视网膜移位术后3天、7天和14天对3只兔进行视网膜电图检查。在视网膜移位术后7天对1只兔进行组织学研究。

结果

我们的结果基于对最后连续15只兔进行的实验。术后1天,15只动物中有14只观察到视网膜复位。其余动物发生了眼内炎。实现了约1000微米的可预测视网膜移位。1周后4例在视网膜皱褶处发现视网膜裂孔。视网膜电图研究显示视网膜功能短暂降低。组织学上可见视网膜外层有轻度形态学损伤。在随访的14天内,任何兔均未发生视网膜脱离或增殖性玻璃体视网膜病变。

结论

在兔中实现了有限的视网膜移位及中央视网膜复位。

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