羊膜植片在穿透性滤过手术中抑制巩膜瓣下纤维增殖的研究

Anti-proliferative effect of amnion implant in glaucoma filtering surgery in rabbit

目的探讨羊膜植片在兔眼穿透性滤过手术中抗纤维增殖情况。方法将羊膜上皮面朝外折叠成双层植入穿透性滤过手术的兔眼浅层巩膜瓣下。于术后不同时间点,行眼球组织学切片及运用显微图像分析系统对滤过道内成纤维细胞进行记数、分析。结果术后2周滤过道内开始出现成纤维细胞,随时间延长成纤维细胞数目逐渐增多,但无统计学差异(P>0.05)。对照组由术后1周开始出现纤维增殖,且逐渐加重,术后2周滤过道大部分封闭,术后3周已有新生血管长入。实验组和对照组的成纤维细胞数在术后1、2、3、4周分别进行比较,有显著性差异(P<0.05)。结论羊膜植片应用于穿透性滤过手术,可明显抑制滤过道使成纤维细胞增殖,滤过道保持通畅。

Objective To study if amnion implant ca n prevent and inhibit the fibroblast proliferation and scar formation during th e glaucomatous filtrating surgeries in rabbit eyes.Methods Glycerin stored hum an amnion with epithelium outside were surgically put under the scleral flaps o f rabbit eyes in experimental group during the trabeculectomy procedures.HE st ainings,light microscope and microphoto-analyses technique were used to obser ve the fibroblast proliferation and scar formation at different time points in post-operation.Results Fibroblast were revealed in the filtrating pathway at the2 nd week post-operation,the numbers of the fibroblasts were generally increase d,but there was no statistic difference in different time points(P>0.0 5).Severe fibroblast proliferation and randomly arranged fibrocytes were exis ted in the control group with partial filtrating tunnel closure at the1 st week after surgery.By the week2after operation,large amount of fibrobla st filtration and scar formation were found at the tunnels with almost complete closure of filtrating pathways in control group.The number of fibroblasts in th e experimental group and control group was compared respectively at the1 st ,2 nd ,3 rd and4 th week after surgery,showing a significant statistic differences (P<0.0 5).Conclusion Amnion can be successfully used to subscleral-flaps in the ant i-glaucomatous filtrating surgery to prevent the fibroblast proliferation and scar formation,and to keep the filtrating pathways open.