动物实验 z-bo 2020-08-26 567

　　Background: Conjunctival dysplasia (stenosis) is a unique and abnormal eye disease only observed in dwarf rabbits. It looks like a pink double-layer vascular membrane, which completely covers the edges 360 degrees and extends to the center. The rabbit knows very little about this situation. Pink tissue is a type of conjunctival fold, which grows on the edge of the conjunctiva and covers the cornea to varying degrees. The cornea is still attached to the limbus, but the center of the tissue can be freely attached to the corneal surface. In the case of abnormal conjunctival hyperplasia, only pericorneal loosening has been reported. Generally speaking, there are no symptoms of conjunctivitis caused by eye hyperplasia, but in some cases mild inflammation may occur. Corneal edema can occur in the central incision of the conjunctiva. Abnormal conjunctival stenosis mainly occurs in adult animals. Local and systemic drugs cannot effectively prevent further membrane growth. Surgery alone can remove the membrane, but because the membrane grows rapidly, it is not enough to remove the edges of the membrane. After removing the membrane, the edges are sutured to the back of the conjunctiva and sclera. Allgoewer et al. According to reports, 10 eyes of 6 dwarf rabbits successfully used Stades U sutures to treat conjunctival stenosis and abnormal hyperplasia. Another method is to suture the intermittent serosa muscle layer of abnormal conjunctival hyperplasia. Treatment with steroids and cyclosporine is ineffective, but topical cyclosporine ointment is usually used for postoperative correction to reduce the risk of renewal.

　　Case introduction: Medical history and eye examination results: A 10-month-old male dwarf rabbit’s cornea is covered with a layer of pink fleshy vascular membrane, and the center of the right eye is expanded 360 degrees. Except for the dorsal part, the membrane covers the entire cornea. As the limbus is inserted into the eyelid plate, the conjunctival folds stretch on the cornea. In the absence of corneal epithelial attachment, the elastic membrane is easily removed from the cornea, and there are no other systemic or ophthalmic examination results.

　　Surgery and postoperative care: Conjunctival hyperplasia surgery uses Allgoewer's modified U-shaped nail. After propofol induced anesthesia, the rabbit was intubated with isoflurane to maintain anesthesia. Disinfect the eyes with 0.2% povidone iodine, and divide the conjunctiva attached to the limbus into 6 equal-sized parts from the center to the edge. All the sundries are placed in the normal position on the dome and fixed by the skin mattress suture. After the operation, neomycin, polymyxin B and dexamethasone eye drops were given twice a day for 3 weeks. One week after the operation, all eyelid surfaces showed moderate inflammation. Despite frequent use of dexamethasone eye drops, inflammation persists. The inflammation subsided 3 weeks after the operation, but the conjunctival corneal folds began to grow. Then all sutures are removed, and in the next week, the membrane covers the entire corneal surface except for the small central area. Five weeks after the first operation, the operation was performed using intermittent serum muscle suture and surgical methods. After induction of general anesthesia, the membrane is removed and retracted behind the limbus. Remove the entire film, cut the edge next to the edge, and use intermittent serosal suture. Initially, eight simple intermittent serous sutures were used, followed by continuous intermittent serous sutures on the entire circumference. After the operation, maxitrol eye drops and cyclosporine ointment were used, and there was no eyelid inflammation or eyeball bleeding after the operation. After 4 weeks, there was no sign of recurrence and the drug was stopped. The rabbit was followed up for 11 months and relapsed without symptoms.

　　Conclusion: Allgoewer's method is used for the first operation. After the operation, moderate eyelid inflammation occurred and lasted for 1 week. Three weeks after the operation, the conjunctival folds grew again at the limbus, and within a week, the membrane expanded and covered most of the cornea. Despite using maxitrol eye drops, the eyelids and conjunctiva still showed signs of inflammation. Another surgical method is used to treat recurrence. Similar to the method introduced by Turner, peel off the entire film and fold the trimmed edge to the edge. 8 simple intermittent serous sutures followed by intermittent serous sutures. When using

　　It is difficult to suture the third eyelid into the eye with

　　full stitch. The six radial membranes shrink after cutting, making it difficult to treat with surgery. Blepharitis still persists after the first surgery and even after using steroid eye drops. This inflammation was not observed after the second operation, but it may be due to the irritation of the eyelids with suture material (polypropylene) during the first operation.