LASIK术中负压吸引对家兔视网膜氨基酸含量的影响

目的研究准分子激光角膜原位磨镶术（LASIK）术中瞬时高眼压对视网膜氨基酸质量浓度的影响。方法60只健康新西兰大耳白兔随机分为对照组、负压吸引20S组、负压吸引45s组和负压吸引3min组，制作瞬时高眼压模型。对照组只进行激光治疗；负压吸引组用负压发生器吸引兔眼角巩膜缘，分别持续20S、45S及3min，在术后不同修复期采用高效液相色谱分析仪检测视网膜4种氨基酸质量浓度的变化，并与对照组进行比较。结果负压吸引20S组及45s组视网膜氨基酸质量浓度与对照组比较差异无统计学意义（P〉0．05）。负压吸引3rain组视网膜中4种氨基酸质量浓度与对照组比较差异有统计学意义（P〉0．05）。术后即刻（0d）谷氨酸（Glu）质量浓度与对照组比较差异无统计学意义（t=-2．165，P=0．083）；术后7、10、14、28d与对照组比较差异均有统计学意义（t=-22．984，P=0．000；t=-61．437，P=0．000：t=-15．957，P=0．000；t=-21．336，P=0．000）。术后即刻（0d）和7d谷氨酰胺（Glune）、色氨酸（Try）、苯丙氨酸（Phe）质量浓度与对照组比较差异均无统计学意义（P〉0．05）；术后10、14、28d与对照组比较差异均有统计学意义（P〈0．01）。结论LASIK术中负压吸引引起的眼压急剧升高可引起视网膜中4种氨基酸水平的可逆性升高，负压吸引时间越长改变越明显。

The influence of negative suction during LASIK on content of retinal amino acids in rabbit

Background Whether negative suction during excimer laser in situ keratomileusis(LASIK) affect the structure and function of retina or not is in controversy,but it seems that temporary hypertention induced by negative suction is a key factor of impairment of retina in LASIK.ObjectiveThis study attempts to study the influence of transient high intraocular pressure (IOP) during LASIK on the contents of retinal amino acid.MethodsThe both eyes of 45 New Zealand white rabbits were suctioned for different periods (20s,45s,3min) with negative pressure generator during the LASIK to make the instantaneous high IOP models,and LASIK without negative suction was performed in the both eyes of 15 rabbits in the control group.The changes of the contents of retinal amino acids were evaluated with High Performance Liquid Chromatography(HPLC) at 0,7,10,14 and 28 days postoperatively and compared with those of control group.ResultsThere were no statistically significant differences in the contents of retinal amino acids among different time points after operation in negative suction for 20s group and 45s group,respectively(P＞0.05).At negative suction for 3minuts,the content of glutamic acid in retina was significantly increased in comparison with control group in 7,10,14 and 28 days (P＜0.05),and no statistically significant difference was seen in the contents of glutamic acid at postoperative instant group compared with control group(P＞0.05).A statistically significant difference in the contents of glutamine,tryptophan,phenylalanine was revealed among postoperative 10 days,14 days and 28 days groups comparison with control group (P＜0.05).ConclusionThe acute IOP elevation caused by negative suction during LASIK results in the reversible increase of retinal amino acids.The duration of negative suction time influent the reconstruction of retinal structure.