Objective To investigate the stimulating effects of conjunctival sac implants following eye enucleation on orbital bone tissue in rabbits model.Methods Eighty 1-month-old New Zealand rabbits were randomly divided into normal control group,only eyeball enucleation group,2-week interval group and 4-week interval group.The right eyeballs were enucleated in the rabbits in the only eyeball enucleation group,2-week interval group and 4-week interval group,and conjunctival sac implants were placed intraoperatively.Then a larger implant was replaced in a 2-week interval or 4-week interval in different groups,respectively.Spiral CT scan was used to evaluate the orbital bone development with aging.The peripheral blood of 3 ml was collected in the rabbits for the detection of osteocalcin and alkaline phosphatase using osteocalcin test kit (N-MID Osteocalcin) and alkaline phosphatase assay kit (NPP substrate-AMP buffer method),respectively.The animals were sacrificed at 3 months after operation for the histopathological examination of orbital bone tissue.Results The operation was successful in all the rabbits and no infection occurred after operation.The variance of orbital bone CT value was obvious in all the rabbits.The intercalated osteocalcin concentration was (48.55 ± 7.99),(59.80 ± 2.96),(57.94 ± 5.20) and (55.96 ± 3.22) μg/L and the alkaline phosphatase concentration was (284.66± 132.69),(232.96±54.39),(232.40± 118.23),(284.20± 130.41) μg/L in the normal control group,only eyeball enucleation group,2-week interval group and 4-week interval group,respectively,showing insignificant differences among the four groups (F =2.710,0.281,both at P ＞ 0.05).Similar pathological findings were in the 2-week interval group and 4-week interval group,such as no obvious orbital bone malformations,weak bone absorption and few bone osteoclasts under the optical microscope.Varying degrees of orbital deformities and bone tissue absorption were found in the only eyeball enucleation group.No orbital bone developing abnormality was seen in the normal control group and the left eyes in various groups under the optical microscope.Conclusions Compared with the only eyeball enucleated eyes,the orbital bone tissue has a well developed process in conjunctiva sac implant eyes following eyeball enucleation.Conjunctiva sac implant is an effective method to stimulate orbital growth and orbital volume increasing.%目的 观察眼模置入幼兔结膜囊后其眼眶骨组织的变化. 方法 选用1月龄新西兰幼兔80只,随机分为正常对照组、间隔2周组、间隔4周组和单纯眼球摘除组,每组20只.间隔2周组、间隔4周组和单纯眼球摘除组兔摘除右眼球,左眼保留,间隔2周组兔术后每隔2周更换1次更大号眼模,间隔4周组每4周更换1次更大号的眼模;单纯眼球摘除组兔仅摘除眼球但不置人眼模;正常对照组不做任何处理.采用螺旋CT扫描法测定兔眼眶骨CT值;采集实验兔静脉血各3 ml,分别采用骨钙素检测试剂盒(电化学发光法)和碱性磷酸酶测定试剂盒(NPP底物-AMP缓冲液法)测定骨钙素和碱性磷酸酶质量浓度.术后3个月处死实验动物制备双眼眼眶骨切片行常规组织病理学观察. 结果 各组兔术眼手术顺利,术后无感染.各手术组兔眶骨CT值测量值方差较大,差异无统计学意义.正常对照组、单纯眼球摘除组、间隔2周组和间隔4周组血骨钙素质量浓度分别为(48.55±7.99)、(59.80±2.96)、(57.94±5.20)和(55.96±3.22)μg/L,血碱性磷酸酶质量浓度分别为(232.40±118.23)、(284.20±130.41)、(284.66±132.69)和(232.96±54.39) μg/'L,组间总体比较差异均无统计学意义(F=2.710、0.281,P＞0.05).光学显微镜下各组兔右眼眼球摘除后均有不同程度眼眶发育畸形及骨组织吸收现象,间隔2周组与间隔4周组骨切片组织病理学表现相似,未见明显眶骨组织发育畸形,骨吸收现象较弱,间隔4周组少数几张视野可见破骨细胞;单纯眼球摘除组可见明显眶骨组织发育畸形,骨吸收现象明显,可见较多破骨细胞;正常对照组及各手术组兔左眼眶骨未见组织病理学表现异常.结论 与眼球摘除后不置入眼模兔比较,眼球摘除后结膜囊置人眼模眼眶骨组织发育更好.眼球摘除后结膜囊置入眼模可刺激眼眶骨的发育.
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