| The Effects of Intracameral Injection of Various Antibiotics on Rabbit Corneal Endothelium. |
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Won Ryul Lee, Jae Ho Kim |
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Department of Ophthalmology, Kangnam St. Mary's Hospital, Catholic Medical College, Seoul, Korea. |
| 전방내 항생제 주입이 가토의 각막 내피세포에 미치는 영향 |
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이원렬(Won Ryul Lee),김재호(Jae Ho Kim) |
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| Abstract |
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To evaluate the short term effects of antibiotics on corneal endothelium, we injected relatively high dosage of antibiotics into the anterior chamber. The experimental dosages of antibiotics used were 4,000 ug of gentamicin, 4,000 ug of amikin, 3,300 ug of cefamezin and 3,300 ug of kedacillin. The effects of these antibiotics on the rabbit corneal endothelial structure and function were evaluated by using ultrasonic pachometer, specular microscope, trypan blue vital staining and electron microscope at 3 hours, 2 days and 7 days following the intracameral injection. For this study 16 rabbits were used for histologic examination and 14 rabbits were used for measuring corneal thickness and endothelial density. The results were as follows: 1. There were no meaningful increases in corneal thickness at 3 hours after intracameral injection of the four antibiotics. However, at 2 days after intracameral injections, the four antibiotics affected significant increases in corneal thickness, i.e., gentamicin, 21 um, amikin, 14 um, cefamezin, 21 um, and kedacillin, 20 um. And at 7 days after the intra cameral injections, the increases of corneal thickness were gentamicin, 20 um, amikin, 18 um, cefamezin, 27 um, and kedacillin, 25 um and these differences were significant statistically. 2. The degrees of corneal thickness change with time lapse after intracameral injection of various antibiotics were as follows: a) from 3 hours to 2 days: gentamicin, 20 um, amikin, 12 um, kedacillin, 14 um, cefamezin 12 um. b) from 2 days to 7 days: gentamicin. -1 um, amikin, 4 um, cefamezin, 6 um, kedacillin, 5 um. The above results showed larger increments in 3 hours to 2 day changes than in 2 to 7 day changes. 3. There were no meaningful decreases in corneal endothelial density at 3 hours, 2 days and 7 days after injection of gentamicin, amikin and kedacillin compared to preintracameral injection values. However in the case of cefamezin, there was a significant descrease of 1.9% in endothelial density at 7 days after injection compared to preintracameral injection value. 4. No meaningful differences were found in trypan blue vital staining and flat preparation between the antibiotics. In the case of trypan blue vital staining, average of 16.5% of endothelial cells stained with trypan blue at 3 hours after intracameral injections, and less than 10% of endothelial cells were stained at 2 days and 7 days after intracameral injections. Flat preparations showed edematous change of endothelial cells at 2 days after intracameral injection of antibiotics. 5. In transmission electron microscope studies, similarities were found in the ultrastructural change between the antibiotics. At 2 days following intracameral injection, affected cells showed some detectable cellular edema with minimal dilatation of the endoplasmic reticulum and minimal swelling to the mitochondria. In view of the above results, increase of corneal thickness and cellular edema were found at 2 days after intracameral injection of gentamicin 4,000 ug, amikin, 4,000 ug, cefamezin 3,300 ug and kedacillin 3,300 ug. Howeveer we could find out that the function and structural change of corneal endothelium returned to normal condition at 7 days after intracameral injections and that the endothelium can tolerate relatively high dosage of antibiotics. |
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