摘要
目的探讨玻璃体腔内注射纤维蛋白溶解酶、透明质酸酶以及两酶联合使用时的安全用药剂量,并评价其造成玻璃体后脱离的程度。方法新西兰大耳白兔48只,随机均分为6个组,每只兔任意1只眼为实验眼,另1只眼为对照眼。每组实验眼于视乳头前玻璃体后1/3注射不同的药物及剂量:1组:透明质酸酶20 IU、平衡盐溶液(BSS)0.1 ml;2组:透明质酸酶30 IU、BSS 0.1 ml;3组:纤维蛋白溶解酶1 IU、BSS 0.1 ml;4组:纤维蛋白溶解酶2 IU、BSS 0.1 ml;5组:纤维蛋白溶解酶3 IU、BSS 0.1 ml;6组:透明质酸酶20 IU、BSS 0.05 ml,联合纤维蛋白溶解酶1 IU、BSS 0.05 ml。所有对照眼相同部位注入BSS 0.1 ml。注药后进行裂隙灯、+90 D前置镜、间接检眼镜、视网膜电流图(ERG)、B超及相干光断层扫描检查,观察2周后,眼球组织标本做光镜及扫描电镜观察。结果1组、3组以及6组兔实验眼未发生眼内炎性反应及视网膜毒性反应;2组和4组兔实验眼均发生眼内轻微炎性反应,视网膜组织结构未见明显异常,但后者ERG显示有可逆性降低;5组兔实验眼发生较严重的眼内炎性反应,且ERG及视网膜组织学出现改变。1-5组均未发生完全性玻璃体后脱离,6组成功诱导出完全性玻璃体后脱离。结论玻璃体内注射透明质酸酶20 IU和(或)纤维蛋白溶解酶1 IU对视网膜及其他眼内组织安?
Objective To investigate the safety dosage of intravitreal injection of Plasmin, Hyaluronidase and their combination and to evaluate their efficacy in the formation of posterior vitreous detachment(PVD) through animal experiments. Methods Eight rabbits each were randomly assigned to one of six groups and one eye of each rabbit were experimental eye, the other is control eye. The position of drug injection was in posterior 1/3 of vitreous before papillary. The drug-injection groups were assigned as following: the first group-Hyaluronidase 20 IU(0. 1 ml BSS) , the second group-Hyaluronidase 30 IU (0. 1 ml BSS) , the third group-Plasmin 1 IU(0. 1 ml BSS) , the forth group-Plasmin 2 IU (0. 1 ml BSS) , the fifth group-Plasmin 3 IU (0. 1 ml BSS), the sixth group- Hyaluronidase 20 IU(0. 05 ml BSS) combined with Plasmin 1 IU(0. 05 ml BSS) ; the control eyes were injected with BSS(0. 1 ml ) at the same position. The experimental rabbits were followed for 2 weeks, and in this period all eyes were examined with slit-lamp biomicroscopy, + 90 D preset lens, indirect ophthalmoscope, electroretinography, B-scan, and optical coherence tomography. After two weeks, the animals were killed and the eyes enucleated. Scan electron and light microscopy were performed. Results Hyaluronidase concentration of 20 IU, Plasmin concentration of 1 IU and their combination didn't produce inflammatory response and retinal toxicity in the experimental eyes. 30 IU Hyaluronidase and 2 IU Plasmin both caused mild inflammatory response in the vitreous without retinal histological changes, while the latter caused a reversible decrease in the ERG b-wave. 3 IU of Plasmin caused severe inflammatory response with retinal histological and electroretinographic changes. In safety dosage neither Hyaluronidase nor Plasmin alone were successful in producing completely posterior vitreous detachment (PVD) , but the latter can produce partial PVD. The combination of Plasmin (1 IU) and Hyaluronidase(20 IU) was effective on producing completely PVD without retinal toxicity. Conclusion 20 IU of Hyaluronidase and 1 IU of Plasmin are safe to retina and others structures in the eyes without any toxicity. Posterior vitreous injection of Hyaluronidase (20 IU) combined with Plasmin (1 IU) can produce complete posterior vitreous detachment. (Chin J Ophthalmol, 2004, 40: 459-464)
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2004年第7期459-464,共6页
Chinese Journal of Ophthalmology
