外伤性白内障摘除人工晶体植入术后房水炎细胞研究

目的动态观察兔眼外伤性白内障囊外摘除及后房型人工晶体囊袋内植入术后早期炎症反应中房水细胞学动态变化．方法青紫兰兔27只，分为外伤性白内障晶体囊外摘除及后房型人工晶体囊内植入组，晶体囊外摘除组和正常对照组。术后d1、d3、d7和d14抽取房水计数白细胞总数及分类。采用SAS软件包，对统计资料作方差分析．结果外伤性白内障囊外摘除及后房型人工晶体囊袋内植入术组房水白细胞总数及各项分类计数明显高于单纯晶体囊外摘除组，差异有显著性．结论术后在d1房水白细胞总数、嗜中性粒细胞和嗜酸性粒细胞增加可能与手术所致的机械性创伤及血－房水屏障破坏有关，术后7～14d房水巨噬细胞增多可能是对人工晶体材料的一种免疫反应所致。     

外伤性白内障摘除及人工晶体植入术后眼内纤维膜形成的实验研究

目的动态观察兔眼外伤性白内障摘除及后房型人工晶体植入术后眼内纤维膜形成的病变特征及规律。方法青紫兰兔１８只分为囊外摘除及后房型人工晶体囊袋内植入组及晶体囊外摘除组。术后１、３、７、１４天用裂隙灯显微镜观察眼前房水纤维蛋白反应。术后１、７、１４天切取每个眼球的虹膜和睫状体，光镜和透射电镜观察虹膜和睫状体及人工晶体表面的纤维蛋白反应。结果发现前房纤维蛋白反应在人工晶体植入术后３天最重，至第１４天减轻。光镜和电镜观察发现，术后第１天虹膜和睫状体表面被渗出的纤维蛋白覆盖，术后第７～１４天，虹膜前、后表面、睫状体表面和人工晶体表面及瞳孔区均可见连续的纤维膜形成，纤维膜内可见大量胶原纤维和成纤维细胞及上皮样细胞。结论外伤性白内障摘除及后房型人工晶体植入术后前房纤维蛋白反应和术后７天眼内纤维膜形成高于单纯晶体囊外摘除组（Ｐ＜０．０５）。推测眼内纤维膜的形成可能与血－房水屏障破坏和免疫反应有关。     

人工晶体植入术后房水肿瘤坏死因子和白细胞介素1含量的研究

目的从兔眼人工晶体植入术后房水肿瘤坏死因子（ｔｕｍｏｒｎｅｃｒｏｓｉｓｆａｃｔｏｒ，ＴＮＦ）和白细胞介素１（ｉｎｔｅｒｌｅｕｋｉｎ１，ＩＬ－１）的活性及动态变化，探讨它们对术后眼内炎症反应的影响。方法青紫蓝兔２７只，分为晶体囊外摘除及后房型人工晶体囊袋内植入术组；晶体囊外摘除术组；正常对照组。于术后１、３、７和１４天抽取房水，采用ＥＬＩＳＡ双层夹心法检测ＴＮＦ，采用ＭＴＴ比色法检测ＩＬ－１。结果房水ＴＮＦ含量和ＩＬ－１活性在人工晶体植入术组术后第１、３、７及１４天高于正常对照组，ＴＮＦ含量在术后３、７、１４天，ＩＬ－１活性在术后１、３天高于晶体囊外摘除术组（Ｐ＜０．０５）。人工晶体植入术后第７～１４天房水ＴＮＦ含量最高，术后第３～１４天ＩＬ－１活性最高。结论人工晶体植入术后房水ＴＮＦ和ＩＬ－１在术后早期眼内炎症反应中作为炎症介质，起着重要作用。     

人工晶体植入术后兔眼虹膜和睫状体病理形态学研究

目的动态观察兔眼后房型人工晶体植入术后虹膜和睫状体的病变特征及规律，探讨术后眼内炎症反应的发生机理。方法青紫蓝兔２７只，分为晶体囊外摘除及后房型人工晶体囊袋内植入组；晶体囊外摘除组；正常对照组。术后１、７、１４天分别切取每个眼球的虹膜和睫状体，光镜观察虹膜、睫状体及晶体囊膜的病理变化，计数炎性细胞。采用ＳＡＳ软件包，对统计资料做方差分析。结果眼内炎症反应的早期为急性炎症和渗出性改变，中期为亚急性炎症和肉芽组织形成，后期炎症趋向慢性化，出现纤维化改变，后房型人工晶体囊袋内植入术后虹膜和睫状体各类炎性细胞浸润均明显高于单纯晶体囊外摘除组（Ｐ＜０．０１）。结论术后在虹膜和睫状体内除了巨噬细胞，还可见多数淋巴细胞、嗜酸性粒细胞和浆细胞浸润，提示人工晶体植入术后可能发生免疫反应。     

肝素抑制人工晶体前膜和后发性白内障的临床研究

报告８１只眼行白内障囊外摘除及后房型人工晶体植入术，其中４１只眼术中在皮质冲吸液中加入肝素（２５ｕ／ｍｌ）；另４０只眼作为对照。术后肝素组有１１只眼前房出血，明显多于对照组（Ｐ＜０．０５），但人工晶体前膜及后囊混浊少于对照组（Ｐ＜０．０５）。术后３个月时肝素组的视力明显高于对照组（Ｐ＜０．０５）。     

后房型人工晶体植入术后房角镜观察

目的：观察后房型人工晶体植入术后房角的改变。方法：对３６例（４０只眼）白内障囊外摘除及后房型人工晶体植入术患者进行房角、眼压、视力及眼底等检查。结果：虹膜周边前粘连发生率为８２．５％，人工晶体固定形式中囊袋内与睫状沟固定二者之间差异无显著性（Ｐ〉０．０５），人工晶体水平位与垂直位之间有非常显著性（Ｐ〈０．０１）。结论：本组观察虹膜周边前粘连发生率虽高，但对眼压、视力等无明显影响。     

人工晶体囊袋内植入对白内障术后后囊混浊发生率的影响

目的回顾性研究白内障囊外摘除和白内障囊外摘除联合囊袋内人工晶体植入术后囊混浊发生率。方法对１８５例（２３４眼）老年性白内障囊外摘除和１０２例（１０９眼）老年性白内障囊外摘除联合囊袋内人工晶体植入术后进行６月～３年（平均２６月）随访,观察其后囊混浊情况。结果前者２３４眼中有８９眼（３８％）发生后囊混浊,后者１０９眼中有１８眼（１７％）发生后囊混浊,二者有显著性差异（Ｐ＜０．０５）。结论白内障囊外摘除联合囊袋内人工晶体植入能降低后囊混浊发生率。     

后房型人工晶体巩膜缝线固定术

本研究主要探索白内障囊内摘除术后或白内障囊外伴后囊破损者，采用巩膜缝线固定技术植入后房型人工晶体的临床效果及并发症。２３例（２３眼），１３眼为白内障囊内摘除无晶体眼，１０眼为白内障囊外摘除术后后囊破裂或外伤性白内障后囊不完整，用巩膜缝线固定晶体襻技术植入后房型人工晶体。本组病例随访３－１６个月（平均８．３个月），视力在４．７（０．５）以上者２１眼，５．０（１．０）以上者１３眼，未发现严重手术并发症     

肝素抑制后发性白内障形成的临床研究

报告老年性白内障４７只眼行囊外摘除及后房型人工晶体植入术，其中２２只眼术中于皮质冲吸液中加入肝素（２５Ｕ／ｍｌ）；另２５只眼作为对照。术后肝素组有２只眼前房出血，但人工晶体前表面沉积物及后囊混浊少于对照组。术后３个月时肝素组视力为０．７０±０．２６，明显高于对照组的０．５４±０．２８（Ｐ＜０．０５）。     

雷公藤多甙治疗人工晶体植入术后眼内炎症反应的临床研究

目的动态观察雷公藤多甙对人工晶体植入术后眼内炎症反应的影响,估价雷公藤多甙的临床治疗效果及其抗炎作用的机制。方法１２０例老年性白内障随机分为２组,施行白内障囊外摘除及后房型人工晶体植入术。１组为雷公藤多甙治疗组;２组为激素治疗组。术后１、３、７及１４天定量观察前房水混浊、人工晶体表面沉着物和纤维蛋白反应。结果雷公藤多甙治疗组术后第１、３、７及１４天房水混浊、人工晶体表面沉着物和纤维蛋白反应低于激素治疗组（Ｐ＜０．０５）。结论雷公藤多甙能降低人工晶体植入术后眼前节炎症反应,雷公藤多甙治疗优于激素治疗。     

兔晶状体摘除和人工晶状体植入术后房水细胞因子水平和一氧化氮含量与眼内炎性反应的关系

目的：探讨晶状体摘除和人工晶状体植入术后房水中白细胞介素（interleukin,IL）-2、肿瘤坏死因子（tumour necrosis factor,TNF）-α水平及一氧化氮（nitric oxide,NO）含量与眼内炎性反应严重程度之间的关系。方法：将18只新西兰白兔随机分成3组,每组6只兔。Ⅰ组为正常对照组,Ⅱ组行囊外晶状体摘除术,Ⅲ组行囊外晶状体摘除及人工晶状体囊袋内植入术。分别于术后0、1、3、7、14及30d检查各组动物角膜水肿及前房渗出情况,抽取房水做房水细胞计数及分类,同时测定房水中细胞因子IL-2和TNF-α水平及NO2^-/NO3^-含量,并观察其变化。结果：Ⅲ组术后7-14d,前房渗出程度最严重,房水中单核/巨噬细胞数目最多。术后1-14dⅢ组房水中IL-2、TNF-α和NO2^-/NO3^-含量均明显高于Ⅰ、Ⅱ组,并于术后3-7d达高峰,2周后逐渐降低。各组房水IL-2、TNF-α、NO2^-/NO3^-含量和眼内炎性反应的严重程度变化规律基本一致,即炎性反应重时含量高。结论：人工晶状体植入术后眼内炎性反应的严重程度与房水细胞因子IL-2和TNF-α水平及NO含量变化有密切关系。     

兔角膜穿孔后房水内丙二醛的测定

兔角膜穿孔伤后,房水中丙二醛含量与正常相比显著增高,P<0.001。提示前房内发生了脂质过氧化反应。这一发现有助于对眼前节炎症反应的进一步认识。     

人工晶状体植入术后NO、IL-8、Ca2+的动态变化

目的 研究白内障超声乳化术和囊外摘出术后房水中一氧化氮(NO)、白介素—8(IL—8)、钙离子(Ca^2 )动态变化；探讨术后炎症反应程度。方法 30只家兔分为超声乳化术组、囊外摘出术(ECCE)组和正常对照组，测定各组术后1、3、7、14、28d房水中NO、Ca^2 、IL—8含量。28d取植入的人工晶状体做病理分析。结果 术后房水中NO、IL—8含量升高，Ca^2 含量降低。超声乳化组NO、IL—8含量低于ECCE组而Ca^2 含量无差异。术后28d植入品状体表面可见吞噬细胞沉积；超声乳化术组比ECCE组吞噬细胞数明显减少。结论 NO、IL—8、Ca^2 参与术后眼内炎症反应；超声乳化术组炎症反应轻。     

Assessment of nitric oxide level in aqueous humor under physiological conditions and after lens extraction with PMMA during experimental work in rabbits

PURPOSE: To evaluate the presence of nitric oxide and measure its level in the aqueous humor of the rabbit's eye, in physiological conditions and after extracapsular lens extraction and PMMA artificial lens implantation. We also investigated nitric oxide maintenance during early postoperative period (between 1-5 day after surgery). MATERIAL AND METHODS: We used 30 rabbits (weighing 3.0-3.5 kg) Just before surgery samples of aqueous humor were aspirated by anterior chamber puncture. Lens was extracted with extracapsular (envelope) technique. In 15 eyes PMMA IOL was implanted in the bag and 15 eyes were left aphakic. The aqueous samples were collected on 1st, 3rd, 5th days after surgery. Nitric oxide in each sample was measured with respect to fluorometric assay. RESULTS: In aqueous humor in physiological conditions we detected nitric oxide. Its level was estimated on the value of 26.52 nM/dl. After extracapsular lens extraction in both groups the level of nitric oxide was significantly higher than in control group. The day and value of NO level was different among examined groups. Nitric oxide level diminished significantly on 5th postoperative day. CONCLUSION: We came to conclusion that after ECCE and PMMA IOL implantation NO level was significantly higher as compared with control. This higher NO level after lens extraction can be responsible for the blood aqueous breakdown.     

糖尿病白内障人工晶状体植入术临床分析

目的分析基层医院开展糖尿病白内障摘出联合后房型人工晶状体植入术的临床疗效。方法我们对46例(46眼)糖尿病白内障行现代囊外摘出联合后房型人工晶状体植入术，并设46例(46眼)老年性白内障患者行现代囊外摘出联合后房型人工晶状体植入术为对照。结果糖尿病白内障术后角膜内皮水肿、房水浑浊、纤维素样渗出、瞳孔后粘连、后囊浑浊等眼前段手术并发症发生率高于老年性白内障，但经正确有效处理，总体预后两组并无显著差异。结论糖尿病患者空腹血糖控制在8．0mmol／L以下，行白内障摘出后房型人工晶状体植入是安全的。     

人工晶状体植入术后炎性并发症与内皮素-1、白细胞介素-8的关系

目的 探讨血浆和房水内皮素－１（ＥＴ－１），白细胞介素－８（ＩＬ－８）与人工晶状体植入术后炎性并发症关系。方法 对４０例晶状体囊外摘出后房型人工晶状体植入术后３种不同级别炎性并发症家兔进行血浆和房水ＥＴ－１，ＩＬ－８测定，检测方法为放射免疫测定。结果 ４０只家兔ＥＴ－１，ＩＬ－８术后在血浆和房水内较术前均升高，且与术后炎性并发症呈正相关。结论 检测血浆和房水中ＥＴ－１、ＩＬ－８水平可作为监测术后恢复情况，估计预后及转归的实验室指标。     

兔眼人工晶状体植入后房水基质金属蛋白酶及其抑制因子活性的动态变化

目的 探讨白内障囊外摘出及人工晶状体植入术后房水中基质金属蛋白酶(MMPs)活性及其抑制因子(TIMPs)的动态变化。 方法20只健康成年家兔,均1眼行晶状体囊外摘出及人工晶状体植入术,另一未手术眼作为对照组。每4只兔为一组,分别于术后第1、3、7、14、30 d抽取房水,用酶谱分析法和反向酶谱分析法检测各标本中的MMPs的活性及TIMPs量的变化。 结果 正常对照组兔眼内有MMP-2、-7的表达,而MMP-1、-9的表达甚微;术后第1d,房水中MMP-1、-2、-7、-9、TIMP-1和TIMP-2的活性明显升高,这种高水平可持续到术后第14 d,并有显著性差(P<0.05),但在术后第30d其活性仍高于正常对照组(P<0.05)。 结论 MMPs可能是白内障术后眼内炎症的重要炎症介质之一;MMPs/TIMPs平衡的破坏可能影响了白内障囊外摘出及人工晶状体植入术后细胞外基质的降解,表明TIMPs可能是后囊膜混浊的形成和纤维化的重要原因之一。     

Direct measurement of nitric oxide levels in aqueous humor with selective iso-NO electrode under physiologic conditions and after extracapsular cataract extraction and artificial lens implantation with PMMA in experiments with rabbits

PURPOSE: To estimate the level of the nitric oxide (NO) within the aqueous humor of the rabbit eye after ECCE and PMMA artificial lens implantation using selective, nitric oxide sensitive electrode Iso-NO. We analysed the NO level during early postoperative period between the 1st and the 5th day. MATERIAL AND METHODS: We examined 30 gray rabbits (weighing 3.0-3.5 kg). Just before surgery, samples of aqueous humor were aspirated to control the NO level in physiological condition. Lens was extracted with ECCE (envelope) technique. In 15 eyes PMMA IOL were implanted and 15 eyes were left aphacic. The aqueous samples were also collected 1, 3, 5 days after surgery. Nitric oxide in each sample was estimated directly with selective, nitric oxide sensitive electrode Iso-NO. Changing values of the NO concentration during the examination were expressed using evaluation of field under curve in the absolute values. Such results were compared with control group. RESULTS: During physiological conditions the mean value of the field under curve of the NO concentration was estimated as 4987.29 +/- 895.89. After ECCE with or without PMMA artificial lens implantation the levels of the NO were higher as compared to the control group. After ECCE and PMMA artificial lens implantation the highest level of NO was estimated on the 3rd postoperative day (7978.98 +/- 949.77). During the examinations the fields under curve of NO concentration were estimated as 6626.30 +/- 1176.53 and 6288.19 +/- 604.90 (on the 1st and the 5th days, respectively). On all postoperative days, values of the field under curve of NO were significantly higher as compared to the control group. In contrast, after ECCE without lens implantation the highest value of NO field under curve, was estimated on the 1st postoperative day as 11727.83 +/- 1032.44. During the examinations, the fields under curve of NO concentration were estimated as 9841.52 +/- 698.06 and 5446.96 +/- 568.47 (on the 3rd and the 5th postoperative days, respectively). Moreover, on all days of examination the value of NO fields under curve were significantly higher as compared to the control group. CONCLUSION: The level of nitric oxide in aqueous humor after ECCE with or without artificial lens implantation was higher than in the control group. The highest value of the field under curve was estimated on the 3rd postoperative day after ECCE and PMMA artificial lens implantation and on the 1st postoperative day after ECCE without lens implantation. The use of direct selective electrode Iso-NO is a simple method of nitric oxide estimation in aqueous humor, but the interpretation of results seems to be very difficult. This method may be suitable for comparative estimations of NO during the experimental works.     

LMWH inhibits anterior chamber inflammation after extra capsular lens extraction through down regulation of bFGF content in aqueous humor

AIM: To observe the changes of basic fibroblast growth factor (bFGF) content in anterior chamber before and after extra capsular lens extraction for investigating the mechanism of low molecular weight heparin (LMWH) inhibiting anterior chamber inflammation. METHODS: Eighty-four rabbits were randomly divided into control and experimental group, 42 rabbits in each group. Extra capsular lens extraction was done on unilateral eye in each rabbit. LMWH was perfused into anterior chamber by the concentration of 50U/mL at the end of operation in experimental group. The degrees of corneal edema, aqueous flare and fibrin were evaluated with slit lamp microscope on postoperative day 1, 3, 6, 15, 30, 45 and 60, respectively. Six eyes of each group were at each time point. Contents of bFGF in aqueous humor were determined by ELISA after animals were killed. Another six eyes were used for determining the base line level of bFGF in aqueous humor. RESULTS: The degrees of corneal edema, aqueous flare and fibrin in experimental group were significantly lighter than those in control group (P<0.01) on postoperative day 1, 3 and 6, respectively. No difference was showed between the two groups at other point time. Contents of bFGF in aqueous humor increased at the same time. bFGF content reached peak on postoperative day 1 in experimental group, while on postoperative day 6 in control group. Contents of bFGF in the two groups declined slowly after reaching peak. The bFGF content in control group were significantly higher than that in experimental group 1-30 days after surgery (P<0.05). No significant differences were shown between the two groups on postoperative day 45 and 60, respectively. CONCLUSION: Perfusion with LMWH by the concentration of 50U/mL can significantly reduce anterior chamber inflammation after extra capsular lens extraction in rabbits, which may be related to down regulation of bFGF content in aqueous humor.     

Halothane anesthesia and aqueous humor dynamics in laboratory animals

Halothane anesthesia decreased intraocular pressure (IOP) by approximately 4 mm Hg in both normal rabbits and monkeys. The administration of nitrous oxide or 100% oxygen had no effect on IOP. Although PO2 and PCO2 increased following halothane administration in rabbits, similar blood changes occurred without IOP reduction in control rabbits receiving 100% oxygen. Outflow facility in both species as measured by tonography remained unchanged by halothane administration. Aqueous humor flow as estimated by tonography decreased by about 39% in rabbits and 31% in monkeys. Posterior chamber aqueous humor ascorbate was significantly elevated 90 min after halothane administration in rabbits. The ratio of the aqueous humor flow coefficient to diffusion coefficient for ascorbate (kfa/kdpa) was reduced approximately 47% following the administration of halothane. Halothane did not alter the in vitro accumulation of 131I-hippuran or 86Rb by rabbit ciliary body--iris preparations.