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目的 :研究兔晶状体超声乳化术中眼内应用 0 2mg/ml的丝裂霉素C(mitomycin C ,MMC)对术后后囊膜混浊的抑制作用 ,并比较不同给药方式对眼毒性的差异。方法 :将 32只新西兰白化兔随机分为A、B、C、D 4组 ,进行晶状体超声乳化摘除术。A组为空白对照组 ,B组用 0 2mg/ml的MMC溶液在环形撕囊后作水分离 ,C组在术中将混有MMC(0 2mg/ml)的粘弹剂注入空的囊袋中 ,D组将MMC(0 2mg/ml)溶于配好的灌注液中 ,在手术中应用。术后 1个月对术眼进行组织病理学检查。结果 :术后 1个月时光镜下A组中赤道部及中央后囊膜均可见晶状体上皮细胞的明显增生、移行及大量排列紊乱的成纤维细胞和胶原纤维。B、C、D三组中可见赤道部少量残留的晶状体上皮细胞及皮质 ,中央后囊的表面未见晶状体上皮细胞、成纤维细胞或珍珠样小体。透射电镜下 ,D组中虹膜上皮、睫状体上皮及视网膜各层均发生了不同程度超微结构的损伤 ,A、B、C三组间未见明显异常。结论 :眼内应用 0 2mg/ml的MMC明显抑制后囊膜混浊的发展。尽管眼内应用 0 2mg/ml的MMC可以导致眼内组织的毒性 ,但通过改进用药方法和加强保护措施 ,可有效地避免或减少药物的眼毒性。在应用于临床之前 ,仍需进一步动物实验研究。
OBJECTIVE: To study the inhibitory effect of mitomycin C (MMC) 0.2 mg / ml intraocularly on posterior capsular opacification during phacoemulsification in rabbits and compare the differences of ophthalmic toxicity between different modes of administration . Methods: 32 New Zealand albino rabbits were randomly divided into groups A, B, C and D 4 for phacoemulsification. A group was blank control group, B group with 0 2mg / ml of MMC solution in the circumferential after the capsulorhexis for water separation, C group intraoperative mixed MMC (0 2mg / ml) of viscoelastic injected into the empty pocket , Group D MMC (0 2mg / ml) dissolved in a good perfusion solution, used in surgery. One month after operation, histopathological examination of the eye was performed. Results: At 1 month after surgery, the lens epithelial cells in the equator and the central posterior capsule in group A showed obvious hyperplasia, migration and a large number of disorganized fibroblasts and collagen fibers. A small amount of residual lens epithelial cells and cortex were observed in the three groups of B, C and D groups. No lens epithelial cells, fibroblasts or pearloid bodies were found on the surface of the central posterior capsule. Under the transmission electron microscope, ultrastructural damage occurred in the iris epithelium, ciliary body epithelium and retinal layer in group D, and there was no obvious abnormality among the three groups. Conclusion: Intraocular application of 0.2 mg / ml MMC significantly inhibits the development of posterior capsular opacification. Although intraocular application of 0.2mg / ml MMC can lead to the toxicity of intraocular tissues, the ocular toxicity of the drug can be effectively avoided or reduced by improving the method of administration and enhancing the protective measures. Before the clinical application, further animal experiments are still needed.