目的：了解球旁注射高三尖杉酯碱（HHT）联合甲基强的松龙对实验性外伤性增生性玻璃体视网膜病变（PVR）的防治效果。方法：兔扁平部切开8mm，玻璃体腔内注射自血0.2mL，制作实验性外伤性PVR模型，治疗组于手术结束时及术后3d、7d、10d球旁注射高三尖杉酯碱0.5mg及甲基强的松龙10mg，对照组球旁注射等量生理盐水。术后7天内每天散瞳检查眼底，7天后每周散瞳检查眼底及玻璃体情况，了解牵引性视网膜脱离(TRD)及PVR发生情况，共观察4周。结果：4周后，对照组25只兔眼中18眼（72%）出现PVR及TRD，其中7眼出现漏斗状全脱离，治疗组15眼有2眼（13.3%）出现PVR及TRD，治疗组PVR及TRD发生率明显降低，两组比较差异有显著性（P＜0.01)。各期RD发生情况:对照组：术后第7天，所有的25眼视网膜无脱离，14天时，9眼有RD，21天时，15眼有RD。28天时，18眼出现RD。由于玻璃体积血，术后2周以内眼底模糊不清。随着玻璃体积血减轻，逐渐可见玻璃体腔有前后增殖条索及增殖膜，增殖膜起自切口，达后部视网膜，早期出现视网膜浅脱离，晚期出现视网膜漏斗状脱离。治疗组：术后第7天，所有的15眼视网膜无脱离，14天时，1眼有视网膜部分脱离，21天时，2眼有视网膜部分脱离。28天时2眼出现RD，其它13眼在4周内未出现RD，也未见到切口有纤维增殖进入玻璃体。结论：球旁注射HHT联合甲基强的松龙对实验性外伤性PVR有一定的防治作用。

An experimental research on treatment of traumatic proliferative vitreoretinopathy by peribulbar homoharringtonine with methylprednisolone injection. LONG Xinguang, HUANG Yinggui, WANG Yinfen. Department of Ophthalmology, Foshan Hospital of Traditional Chinese Medicine, Foshan 528000
Abstract OBJECTIVES: To evaluate the therapeutic effect of peribulbar homoharringtonine (HHT) with methylprednisolone injection on experimental traumatic proliferative vitreoretinopathy (PVR). METHODS: An experimental model of traumatic PVR was induced in rabbits by intravitreal injection of 0.2mL of autologous blood after an 8-mm incision through the pars plana, then the rabbits were selected randomly to receive either peribulbar HHT with methylprednisolone injection or a placebo injection (control). RESULTS: By the end of fourth week, 18 out of 25 eyes (72%) in control group developed PVR and traction retinal detachment (TRD), while only 2 of 15 eyes (13.3%) in treated group developed PVR and TRD. The difference was significant (P<0.01). CONCLUSIONS: Peribubar HHT with methylprednisolone injection could decrease the incidence of the TRD by PVR in this rabbit model.