目的 评价丝裂霉素(MMC)水凝胶防治兔晶状体摘除术后后囊混浊的作用和安全性.方法 将56只新西兰大白兔随机分为7组,行透明晶体囊外摘除术；其中A组为对照组,术中不注入MMC水凝胶；B～G组为治疗组,分别在囊袋内注入浓度为0.2、0.4、0.6 mg/mL的MMC水凝胶0.1 mL,分别作用3 min及5 min后吸出.结果 各组术后前节炎症和角膜水肿反应显著,1周左右逐渐消失.后囊混浊发生率治疗组低于对照组(P均＜0.05),高浓度组低于低浓度组(P均＜0.05)；房水蛋白含量术后第1天、1周各治疗组高于对照组(P均＜0.05),各组间比较同浓度的长时间组(5 min)高于短时间组(3 min),P均＜0.05.术后1周,除B组外,其他治疗组角膜厚度均大于对照组(P均＜0.05),且作用时间越长,角膜越厚(P＜0.05)；术后个1个月,各组间角膜厚度无显著差异.术后1周、1个月角膜内皮细胞计数治疗组均低于对照组(P均＜0.05)；术后3个月各组间无差异.组织病理学和透射电镜观察显示,术后1个月角膜结构基本恢复正常,治疗组晶状体上皮细胞不同程度体积变小,细胞表面微绒毛消失.结论 丝裂霉素水凝胶虽可导致轻度的角膜毒性反应和血房水屏障的破坏作用,但可显著抑制晶体上皮细胞的增生,从而有效预防晶状体摘除术后后囊混浊的发生.%Objective To evaluate the validity and security of mitomycin C( MMC) aquogel on PCO of rabbits. Methods A total of 56 New Zealand white rabbits were medially divided into 7 groups. Under general anesthesia, right eyes of rabbits were conducted lens extraction in standard way. MMC aquogel of different concentration ( A group as blank control, B group and C group 0.2 mg/mL, D group and E group 0.4 mg/mL, F group and G group 0.6 mg/mL) was injected into capsule for 3 min (B, D, F) or 5 min (C,E,G). Results Inflammation of anterior segment and cornea edema was popular and obvious in each group post-op but disappeared in about 1 week. The incidence of PCO in treatment groups was statistically lower than that in control group, and in higher concentration groups was statistically lower than in lower groups (P<0.05). Aqueous humor protein of treatment groups was higher than that of control group ( P < 0.05). Comparison between the groups in aqueous humor protein rendered a trend that 5 min groups excel 3 min groups (P <0.05). In corneal pachymetry, the treatment groups was thicker than control group except B group ( P < 0.05 ). It was showed that the thickness of 5 min groups was greater than 3 min groups (P <0.05). In corneal endothelial cell counting, the treatment groups was lower than control group (P < 0.05 ) in 1 week, 1 month post-op. There was no difference in corneal endothelial cell counting in 3 month post-op. Histopathology and ransmission electron microscopy showed that cornea restored 1 month post-op. LECs of treatment groups diminished and the microvillus of which disappeared. Conclusion Although MMC may lead to mild toxic side effect of cornea and damage of blood-aqueous barrier, the MMC aquogel is able to prevent PCO by inhibiting lens epithelial cell proliferation.
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