Local hypothermia protects the retina from ischaemic injury in vitrectomy
Department of Ophthalmology, Nagoya City University
Medical School, Japan
Correspondence to: Kazushi Tamai, MD, Department of Ophthalmology, Nagoya City University Medical School, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467, Japan.
Accepted for publication 4 June 1997
AIMS
Hypothermic irrigating solutions were used
during vitrectomy in pressure induced ischaemic eyes so that their
effects on retinal function and histological changes could be investigated.
METHODSAfter anaesthetised albino rabbits
underwent closed vitrectomy, their vitreous cavities were continuously
irrigated for 30 minutes at a perfusion pressure of 140 mm Hg. The
rabbits were divided into three groups according to their intraocular
perfusion temperatures8°C, 22°C, and 38°C.
Electroretinograms were taken before and after irrigation. Glutamate
levels in the vitreous were examined after irrigation. Eyes were
enucleated on the seventh postoperative day and examined histologically.
RESULTSOn the seventh postoperative day, the
recovery rate of a-wave amplitudes was significantly lower in the
38°C group than in the 8°C group, and that of b-wave amplitudes was
significantly lower in the 38°C group than in either the 8°C or
22°C group. Retinal damage in the 38°C group revealed more severe
histological impairment than in either the 8°C or 22°C group.
Oedema of the inner retinal layer was significant in both the 22°C
and 38°C groups. Glutamates reached peak values 30 minutes after the
end of ischaemia in the 38°C group. However, no significant glutamate increases were detected 15 to 60 minutes after ischaemia in either the
8°C or 22°C group.
CONCLUSIONLocal hypothermia during vitrectomy in
acute ischaemic eyes appears to decrease retinal damage.
© 1997 by British Journal of Ophthalmology
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