Adverse Reactions Of Coulentum Entering The Orbital Tissue

Coulentum, a frequently-used formulation in ophthalmic drugs, has advantages of long-term residence in conjunctival sac and reduced friction between the eyelid and the eyeball, but through the surgical trauma or wounds of lacrimal probe or false channels, it may enter the subcutaneous tissue of eyelid, subconjunctival tissue or orbital tissue and will cause severe tissue reaction. In clinical use, there are many cases of severe reactions in orbital tissue due to the entry of ophthalmic ointment after probing of lacrimal passages or laser reconstruction surgery of lacrimal passages, or the packing with vaseline gauze after ENT surgery.This experiment is to establish animal models of adverse reactions by injection of erythromycin ointment (with the matrix of vaseline, lanolin, liquid paraffin) or ofloxacin eye ointment (with the matrix of sodium hyaluronate and carbopol) or hydroxyl-propyl methyl cellulose into the orbit tissue, to observe and compare adverse reactions of orbital tissue.Materials and methodsAnimals and Grouping 63 healthy and clean-level guinea pigs, which were provide by Experimental Animal Center of Zhengzhou University, no gender restrictions, were divided into three groups randomly, each group included 21 guinea pigs. They were all 1 to 2 weeks old,100 g to 140 g weight, excluded a variety of eye diseases, light color around the eyes and easy to observe.Animal model After disinfecting the skin around the eyelid, we injected 10% chloral hydrate (0.3 g/kg) into abdominal cavity for general anesthesia. We used 1 ml syringe with a 22 G needle to puncture into the eyeball, the site of puncture is the skin at the border between the lateral 1/3 and the medial 2/3 of the infraorbital margin. Then injected erythromycin ointment (group A) with the matrix of vaseline, lanolin and liquid paraffin, ofloxacin eye ointment (group B) with the matrix of sodium hyaluronate and carbomer, hydroxyl-propyl methyl cellulose (C group, control group) 0.3 ml into the orbital tissues of a random eye of guinea pigs in the three groups respectively, and the other eye was used for control.Observing items and time points The orbital inflammatory reaction and the degradation of the ointment were observed at 2 hour,1 day,3 day,7 day,14 day,21 day,28 day, respectively.We observed and recorded redness and swollen of the eye, protopsis, resistance after the ball and other inflammatory reactions. At each time for observation, three guinea pigs were randomly selected from each group, which were sacrificed to observe the spread of ointment in the orbit of the gross specimen and observe pathological changes after HE staining.Statistical analysis SPSS 17.0 statistical package was used for the statistical calculation. Rank sum test were used to analyze the difference among the 3 groups. A less than 0.05 was considered as statistical significance.ResultsIn group A, the conjunctival swelling, protopsis and increase in resistance after the ball were the most serious and continued for the longest time. In the early stages, there were mainly the neutrophils infiltration, and there were the hyperplasia of fibroblasts and foreign granuloma node later. The inflammatory infiltration and cell proliferation was the most serious. In group B, inflammatory response was serious during the first 3 days and then disappeared, characterized by inflammatory cells infiltrate (mainly neutrophils and eosinophils), and that the number of inflammatory cells was more than group A, but there was no hyperplasia of fibroblasts.In group C, congestion and edema of the orbital tissue disappeared quickly, the number of inflammatory cells was the least, and there was no fibrosis.There were statistical difference at 3 day (H=9.089, H= 16.830, H=17.084, P < 0.05).ConclusionCoulentum with the matrix of vaseline, lanolin and liquid paraffin may cause the most serious inflammation, and there were fibroblasts hyperplasia and foreign granuloma node, had a relatively long degradable period.Coulentum with the matrix of sodium hyaluronate and carbomer could be degradated and absorbed within 3 days, there was no hyperplasia of fibroblasts.Hydroxyl-propyl methyl cellulose, which only caused a mild inflammation, could be degradated and absorbed within 24 hours, there was no hyperplasia of fibroblasts.