【摘要】 目的观察激光乳化白内障术后兔角膜和视网膜急性超微结构的变化并确定安全的激光能量范围。方法新西兰白兔18只,分为(A、B、C)3组,每组6只,行NdYAG激光乳化白内障手术。A组使用300个脉冲(3J能量);B组使用600个脉冲(6J能量);C组使用900个脉冲(9J能量)。术后0·5h内取中央角膜和后极部视网膜做透射电镜检查。结果A组未见角膜内皮细胞超微结构的异常;B组角膜内皮细胞线粒体肿胀,粗面内质网嵴断裂,内皮细胞空泡变性;C组角膜后弹力层脱离、内皮细胞空泡变性、线粒体肿胀、角膜基质水肿和后弹力层变性。3组均未见视网膜超微结构改变。结论在兔眼NdYAG激光乳化白内障手术中,较少的脉冲和低能量的激光对兔角膜无明显损伤,随着脉冲次数和能量的增加,对角膜内皮细胞的损伤加重。使用9J以下的激光能量,NdYAG激光乳化白内障手术对兔视网膜无急性损伤。更多还原

【Abstract】 ObjectiveNeodymium-yttrium aluminum garnet (Nd:YAG) laser has been used in ophthalmology for photolysis of lens nuclear in recent years.We utilized different laser power for photolysis of lens in rabbit to observe the acute ultramicroscopic structure changes of cornea and retina and to further determine a safe laser energy spectrum.MethodsEighteen eyes of New Zealand white rabbit were divided into 3 groups,and all the right eyes imitated Nd:YAG laser photolysis cataract surgery.Three hundred laser pulses (3 J) were used in group A,600 laser (6 J) pulses in group B and 900 laser pulses (9 J) in group C.Irradiated eyes were enucleated within 0.5 hour after surgery,and the center of the cornea and the posterior pole of the retina were dissected for histology examination under the transmission electron microscope.ResultsCorneal endothelium cell junction damage was found,however, the corneal endothelium cell was normal in group A.In group B,swollen mitochondria were found,and vacuoles were demonstrated in corneal endothelium cells;the rough endoplasmic reticulum was disconnected.In group C,corneal endothelium cell was denuded from Descemet’ membrane,and vacuoles of corneal endothelium cells,edema of mitochondria and stroma,degeneration of Descemet’ membrane also were found in the cornea.The ultramicroscopic structure of the retina was normal in three groups.ConclusionLess laser pulse and smaller irradiating energy can lessen corneal damage during imitating Nd:YAG laser photolysis in cataract surgery.No acute disturbance is found in retina of the rabbit after Nd:YAG laser photolysis.更多还原