摘要
目的 :通过纤维蛋白溶解酶 (以下简称纤溶酶 )和透明质酸酶兔玻璃体腔内注射 ,研究玻璃体视网膜超微结构改变 ,阐明玻璃体后脱离的发生机制。方法 :16只新西兰白兔随机分为A、B、C三组各 8、 4、 4只兔 ,均以右眼为实验眼 ,左眼为对照。A组实验眼玻璃体腔内注射0 1ml纤溶酶 1U联合透明质酸酶 2 0U ,B组注射纤溶酶 1U ,C组注射透明质酸酶 2 0U ,所有对照眼注射 0 1mlBSS液。术后 7天摘除眼球做扫描电镜检查。结果 :扫描电镜发现A组赤道后内界膜 (ILM )表面较光滑 ,残留玻璃体皮质大部分位于直径 2～ 15 μm的小凹陷上方 ,其下为M櫣ｌｌｅｒ细胞足板耆裕校郑?0 0 %。B组后极部ILM表面较光滑 ,残留玻璃体皮质较A组多 ,部分性PVD75 %。C组直径 10～ 3 0nm的玻璃体胶原纤维网状支架塌陷 ,在赤道后平行排列于ILM表面 ,无PVD。所有对照眼无PVD。结论 :药物诱发PVD的实质是解除后界膜与内界膜之间分子胶的粘附。诱发PVD的药物应既能解除玻璃体视网膜界面之间的粘连 ,又能液化玻璃体。纤溶酶 1U联合透明质酸酶 2 0U能诱发出完全性PVD。
Objective:Through vitreous injection of plasmin or hyaluronidase,investigate the ultrastructural change of the vitreoretinal interface,and illuminate the mechanism of posterior vitreous detachment (PVD). Methods:Sixteen New Zealand white rabbits were assigned to three groups (8,4,4,respectively).In each group,the right eyes were experimental eyes and the left eyes were control eyes.Experimental eyes in group A received a vitreous injection of plasmin 1U combined with hyaluronidase 20U (0.1 ml reconstituted in balanced salt solution).Eyes in group B received vitreous injection of plasmin alone (1U/0.1 ml).Eyes in group C received hyaluronidase alone (20U/0.1ml).Seven days after injection,all the eyes were enucleated.After fixation,scanning electron microscopy was performed. Results:The diameter of the vitreous collagen fiber was 10～30 nm under scanning electron microscope.The remained vitreous cortex was closely adhered to the pits in the surface of inner limiting membrane (ILM).At the posterior pole or the equator,vitreous collagen ran parallel to ILM.In group A,all the eyes were induced complete PVD 100%(8/8).In group B,the partial PVD was 75%(3/4),one eye was complete PVD.In group C and all the controls,there were no PVD developed (0/4,0/8 respectively). Conclusions:The key for the drugs to induce the PVD,which can perform in clinic,is that they can both dissolve the adhesion between the vitreoretinal interfaces and liquefy the vitreous.Plasmin 1U combined with hyaluronidase 20U can induce complete PVD.
出处
《中国实用眼科杂志》
CSCD
北大核心
2003年第8期579-582,共4页
Chinese Journal of Practical Ophthalmology
