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Experimental Study on the Prevention of Anterior Segment Ischemia by Preservation of Anterior Ciliary Vessels

机译：保留前睫状血管预防前节缺血的实验研究

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Purpose: To observe the effect of preserving anterior ciliary vessels (ACVs) on anterior segments of rabbit eyes undergoing tenotomy of extraocular muscles. Methods: Thirty-two adult New Zealand white rabbits were divided into four groups. Same procedures were done in both eyes in each group except that left eyes underwent preservation of ACVs. In the first group medial and lateral recti, in the second group, superior and inferior recti, in the third group, medial, lateral and superior or inferior recti and in the fourth group, all four recti, underwent tenotomy. Slit-lamp examination, intraocular pressure (IOP) measurement, total protein and lactic acid quantification in aqueous humor were done in all eyes pre- and post-operatively. By four weeks after operation, the eyes were enucleated for histological examination and electron microscopy. All data were analyzed using SPSS version 10. Results: In the left eyes of both group 1 and group 2, no inflammatory response was observed. In the left eyes of group 3 and 4, we observed mild inflammatory response with slit-lamp examination, which disappeared in one wk. However, we did not find significant changes in IOP, total protein and lactic acid of aqueous humor, histology and electron microscopic examination in these groups. In the right eyes in group 2, 3 and 4, we observed moderate to severe inflammatory changes, a few even developed anterior segment ischemia, appeared as decreased IOP, increased total protein and lactic acid in aqueous humor, along with pathological and electron-microscopic changes. Conclusion: Simultaneous tenotomy of three or four recti or two vertical recti on one eye may decrease anterior segment blood flow even lead to ischemia. ACVs preservation may protect the blood circulation in anterior segment. Our study suggests that ACVs preservation in strabismus surgeries especially those involving multi-recti tenotomies may prevent potential anterior segment ischemia.
机译：目的：观察保留前睫状血管（ACV）对进行眼外肌切开术的兔眼前节的作用。方法：将32只成年新西兰白兔分为四组。除保留左眼ACV以外，每组的两只眼睛都进行了相同的操作。在第一组的内侧和外侧直肠，在第二组的上方和下方直肠，在第三组的内侧，外侧和上方或下方直肠，而在第四组中，所有四个直肠都进行了腱切术。术前和术后所有眼睛均进行裂隙灯检查，眼内压（IOP）测量，房水中总蛋白和乳酸定量。术后四周，摘除眼睛，进行组织学检查和电子显微镜检查。使用SPSS版本10分析所有数据。结果：第1组和第2组的左眼均未观察到炎症反应。在第3组和第4组的左眼中，通过裂隙灯检查观察到轻度的炎症反应，在一星期后消失。但是，在这些组中，我们没有发现房水的眼压，总蛋白和乳酸，组织学和电子显微镜检查有显着变化。在第2、3和4组的右眼中，我们观察到中度至重度的炎症变化，一些甚至发展为前节缺血，表现为IOP降低，房水中总蛋白和乳酸增加，以及病理学和电子显微镜观察变化。结论：一只眼同时进行三，四个或两个垂直的直肠切开术可能会减少前节血流甚至导致缺血。 ACV的保存可以保护前节的血液循环。我们的研究表明，斜视手术中ACV的保存，尤其是涉及多直肠切开术的ACV的保存，可以预防潜在的前段缺血。

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