An Experiment Study On The Prevention Of Posterior Capsular Opacification By The Implantation Of Diclofenace Surface Modified Intraocular Lens In Rabbit Eyes

Objective: This study was design to evaluate the effect and safety of the prevention of posterior capsular opacification by the implantation of diclofenace surface modified intraocular lens in rabbit eyes . Methods: 36 New Zealand rabbits weighing 1.8 to 2.2kg were used .The animals were randomly divided into 4 groups. The IOL were soaked in three different concentration of diclofenace (0.02% 0.1% 0.5%) for 24 hours before operation. The transparent lens phacomulsification were performed in the right eyes and implanted different IOL which had been modified by diclofenace in group B,C and D.Group A served as a control group . The changes of cornea ,anterior chamber were observed everyday in 2 weeks postoperatively; Aqueous humor samples were aspirated from rabbit eye on days 1,2,3,4,7,14 postoperatively;RIA was used to examine the concentration of PGE2 in aqueous. The development of PCO was assessed by slit-lamp biomicroscopy at 4, 8,12 weeks, and photographed by slit-lamp camera . Meanwhile, the histological observeation was performed using the light microscope and electronic microscope at 8,12weeks postoperatively . The data were analyzed statistically by SPSS12.0 for window. Result: 1,The reaction of the conjunctival and the corneal to the surgery. All eyes had conjunctival congestion during the frist 5 days postoperatively ,which disappeared after 1 week. The conea was mild to moderate cornea edema which disappeared spontaneous after 2 to 3 days postoperatively. On the 1th day, the number of eyes that still had cornea edema had no significant difference.(P﹥0.5) 2,The anterior chamber reaction to the surgery. In group A,the degree of anterior chamber flare and cells was the severest and the time was the longest ,while in group C and D the degree was the mildest and the time was the shortest among the four groups .On the 3th day ,there was significant difference between the control group and the other group (P0.05),but there was no significant difference among group B,C and D(P﹥0.5); On the 5th day ,group A was server than group C and group D(P﹤0.05),but there was no significant difference between group A and group B(P﹥0.5) 3,The changes of intraocular pressure. The difference of the intraocular pressure was no significant atdifferent interval time in each group. (P﹥0.5) 4,The changes of the PGE2 concentration in aqueous. The concentration of PGE2 in aqueous rised up in each group postoperatively. However, PGE2 concentration in aqueous in group A was apparently higher than other groups. The group C and group D were the lowest in four groups. There was statistical significance between the control group and the other groups. (P﹤0.05) 5,The number of eyes developing PCO at different time postoperatively. 2 weeks postoperatively , PCO was began developing in group A. By 8 weeks, the number of the eye developed PCO in group A, group B, group C and group D were 9,5,2,2 respectively. By 12 weeks,8 eyes in group A,6 eyes in group B,3 eyes in group C,2 eyes in group D.There was significant difference between the control group and the othere groups at 8 or 12 weeks postoperatively. 6,Histological examination. At 8 weeks postoperatively, it was seen that multiplayer LEC proliferation in the center of the posterior capsule in the control eyes, while in the group C and group D, a few monlayers of LEC proliferation were seen at 12 weeks postoperatively. The obvious pathologic changes were not found in the corneal endothelial cells, which appear regular hexagon in each group. Conclusion: 1,The study suggest that it can prevent the development ofposterior capsular opacification by reduce the degree of BAB disturbance and the inflammatory response to implantation of diclofenace surface modified IOL in rabbit eyes. 2,The experiment showed that the concentration with 0.1% or 0.5% more effective than 0.02% diclofenace in the prevent of posterior capsular opacification. But there was no apparently difference between 0.1% and 0.5%. 3,Intraoperative application of diclofenace by modified IOL is an effective and safe means in preventing PCO. 4,As far as the concertration in this experiment was concerned, the toxicity to the anterior seagment of the rabbit eye was not observed postoperatively.