牛骨异种移植物作为义眼座兔眼眶内植入术

摘要

目的:评价以牛骨作为义眼座在兔眼眶内植入的生物相容性.方法:在兔眼中用牛骨作为植入物,观察其生物相容性及其能否取代昂贵的人造植入物.把12只眼球内容摘除术后的新西兰白兔按眶内有没有植入牛骨分为两组:Y组(6只)为眼球摘除术后眶内没有植入牛骨,X组(6只)为眼球摘除术后植入牛骨.对12只新西兰白兔右眼行眼球内容物摘除,其中6例作为实验组行牛骨植入,6例作为对照组不植入.术后1,7,14,28,42d连续观察术眼的感染情况,植入物的移位情况,伤口愈合情况,眼球运动是否受限.术后42d,摘除实验组眼球,行组织病理检查,检测其炎性反应类型以及纤维血管增生情况.结果:连续临床观察显示:试验组和对照组在术后1d都有轻微的炎症反应,抗生素控制有效.试验组有1例在术后1d发生感染.但没有植入物的移位和脱出,没有伤口的裂开和眼球运动受限,也没有严重的感染和畸形出现.组织病理检查显示牛骨纤维生长良好,有轻微的排斥反应.结论:实验表明在兔眼中,牛骨作为义眼座植入有良好的生物相容性,而且其成本较低,易被接受.%·AIM: To assess the biocompatibility of bovine bone as orbital implants in rabbits.·METHODS: Bovine bone graft was used as an ocular implant in rabbits to determine whether it could be successfully used in the anophthalmic socket as an alternative to the expensive synthetic alloplastics. Evisceration of eyes with and without bovine bone orbital implantation was performed in the right eyes of 12 New Zealand white rabbits.Group Y (n =6) was eviscerated without implant, meanwhile Group X (n =6) was eviscerated with insertion of an orbital implant using bovine bone. Observation was carried out on day 1, day 7, day 14, day 28 and day 42. Serial clinical examination was carried out based on a few fixed criteria,which included rate of infection, implant migration, evidence of wound breakdown and any restriction of intraocular movements. The implanted eyes were then enucleated on day 42. The enucleated eyes were sent for histopathological evaluation to record the type of inflammatory reaction and rate of fibrovascular ingrowth.·RESULTS: Serial clinical examination showed presence of minimal infection in all eyes, both in Group X implanted) and Group Y (control) on first postoperative day, which responded well with antibiotics. Infection occurred in the implanted group after first postoperative day, but there was no evidence of orbital migration or extrusion of implant, wound breakdown, restriction of extraocular movement, severe infection or any physical abnormality. Histopathological examination revealed good fibrovascular ingrowth in the implanted group, with minimal rejecting reaction of rabbit eye towards bovine bone implant.·CONCLUSION: This study shows that bovine orbital implant has a good biocompatibility in rabbit eyes and its cost is acceptable.