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目的 :探讨Nd :YAG激光前囊膜光切术后眼压升高和角膜内皮损伤的发生机制 ,观察丹参和维生素E在其中的保护作用。方法 :2 4兔 ( 48只眼 )随机分为 4组 ,其中药物组激光手术前后应用丹参和维生素E。观察兔眼Nd :YAG激光前囊膜光切术后 2、1 2、2 4、4 8小时的眼压和角膜厚度变化以及房水内丙二醛 (malondialdehyde,MDA)含量的改变。结果 :激光术后眼压升高、角膜增厚 ,并伴随房水内MDA含量明显增加。药物组术后房水内MDA含量无明显增加 ,术后眼压升高、角膜增厚的幅度亦降低。结论 :Nd :YAG激光前囊膜光切术后房水中的MDA含量增高 ,表明前房内发生了脂质过氧化反应 ,提示自由基及其代谢产物是导致眼压升高和角膜内皮细胞损害的病理生理因素之一 ,而眼压的升高可进一步使得角膜内皮屏障功能破坏 ,导致角膜厚度增加。丹参和维生素E可抑制房水内的脂质过氧化反应 ,减轻自由基对眼组织的损伤 ,对激光导致的眼压升高和角膜内皮细胞损害有防治作用。
Objective: To investigate the mechanism of elevated intraocular pressure (IOP) and corneal endothelial damage after Nd: YAG laser anterior capsulotomy, and to observe the protective effect of Salvia miltiorrhiza and Vitamin E in them. Methods: Twenty-four rabbits (48 eyes) were randomly divided into 4 groups, including Salviae Miltiorrhizae and Vitamin E before and after laser surgery. The changes of intraocular pressure (IOP) and corneal thickness (2,1,2,24,88 h) and the contents of malondialdehyde (MDA) in aqueous humor were observed after Nd: YAG laser anterior capsulotomy in rabbit eyes. Results: After laser surgery, intraocular pressure increased, corneal thickening, accompanied by a significant increase in MDA content in aqueous humor. There was no significant increase of MDA content in the aqueous humor after the operation in the medicine group. The intraocular pressure increased and the corneal thickened amplitude decreased after the operation. Conclusion: The content of MDA in aqueous humor after Nd: YAG laser anterior capsule photocoagulation increased, suggesting that lipid peroxidation occurred in the anterior chamber, indicating that free radicals and their metabolites are the cause of increased intraocular pressure and corneal endothelial cell damage One of the pathophysiological factors, and elevated intraocular pressure can further damage the corneal endothelial barrier function, leading to an increase in corneal thickness. Salvia miltiorrhiza and vitamin E can inhibit the lipid peroxidation in aqueous humor, reduce the damage of free radicals to the eye tissue, and prevent and treat the elevated intraocular pressure caused by laser and corneal endothelial cell damage.