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目的观察兔眼晶状体超声乳化吸出术后全反式维甲酸缓释系统(atRA DDS)植入对后囊膜混浊(PCO)的抑制作用,探讨其作用机理及应用的可行性。设计随机对照实验性研究。研究对象 34只新西兰大耳白兔。方法将实验动物随机分为5组,除正常组外,其余各组均行双眼晶状体超声乳化吸出术,对照组不植入DDS,其余三组囊袋内分别植入不同的DDS。主要指标术后不同时期房水中的atRA浓度,不同的DDS植入对兔残留晶状体上皮细胞(RLEC)增生细胞核抗原(PCNA)表达的影响,晶状体后囊膜情况及眼内其他组织情况。结果 75μg和150μg atRA DDS植入组在术后7-15天内保持较稳定的房水atRA浓度,术后2-30天PCNA呈低表达(P<0．05);电镜观察75μg和150μg atRA DDS植入组RLEC移行不明显。各DDS 植入组术后未见毒性反应。结论 atRA DDS可在晶状体摘除术后长期维持较高的房水中atRA浓度,有效抑制RLEC的增生、移行,无明显的毒副作用,有可能成为防治后囊膜混浊的有效方法而应用于临床。
Objective To observe the inhibitory effect of atRA DDS implantation on posterior capsular opacification (PCO) after phacoemulsification in rabbits, and to explore its mechanism of action and the feasibility of its application. Design Randomized controlled experimental study. Study object 34 New Zealand white rabbits. Methods The experimental animals were randomly divided into 5 groups. Except for the normal group, all the other groups underwent phacoemulsification with double phacoemulsification. The control group was not implanted with DDS, and the other three groups were implanted with different DDS. MAIN INDICATION The concentration of atRA in aqueous humor at different periods postoperatively, the effect of different DDS implants on the expression of proliferating cell nuclear antigen (PCNA) in the residual lens epithelial cells (RLEC), the posterior capsular capsule and other tissues in the eye. Results At75 and 150 μg atRA DDS implantation group maintained a stable atra level of aqueous humor within 7-15 days after operation, and PCNA expression was low (P <0.05) 2-30 days after operation. Electron microscopy showed that 75 μg and 150 μg atRA DDS Implantation group RLEC migration is not obvious. No toxic reaction was observed after operation in each DDS implantation group. Conclusions atRA DDS can maintain a high atRA concentration in aqueous humor after lens extraction for a long time and effectively inhibit the proliferation and migration of RLEC without obvious side effects and may be an effective method for preventing and treating posterior capsular opacification.