非穿透小梁手术联合羊膜移植的实验研究

Nonpenetrating trabecular surgery with amniotic membrane transplantation in rabbits

目的探讨羊膜在兔眼非穿透性滤过手术中的作用并为临床应用提供理论依据。方法健康家兔38只分为羊膜处理组(Ⅰ组)、无羊膜对照组(Ⅱ组)及正常对照组(Ⅲ组)。在Ⅰ、Ⅱ组术后第1、2、4、8、12周应用免疫组化方法检测各组眼球壁中TGF-β1、TGF-β2的含量;应用超声生物显微镜(ultrasound biomicroscopy,UBM)观察减压腔内羊膜的情况。结果Ⅱ组中TGF-β1、TGF-β2呈强阳性表达;Ⅰ组中TGF-β1、TGF-β2呈弱阳性表达,相同时相点比较Ⅰ组比Ⅱ组明显弱表达(P<0.01);UBM检查显示所有巩膜瓣下均形成一内含植入物的透明液性间腔,羊膜在术后12周开始降解。结论羊膜组织对兔眼非穿透性滤过手术有抗瘢痕形成作用。

Objective To evaluate the value of amniotic membrane in rabbit nonpenetrating trabecular surgery, and to provide theoretical basis for clinical application. Methods Rabbit eyes were randomly assigned to receive nonpenetrating trabecular surgery in one eye and nonpenetrating trabecular surgery with amniotic membrane transplantation in the other eye. At 1,2,4,8,12 weeks posterior to the surgery, the immunohistochemical technique was used to identify the volume of TGF-β1 or TGF-β2 in all groups, and ultrasound biomicroscopy （UBM） exams were performed. Results In experimental groups, the immunochemical staining showed significantly positive expressions of TGF-β1 and TGF-β2. At different time points, there were slightly positive expressions of TGF-β1 and TGF-β2 in experimental group in comparison with control group. The UBM showed that the amniotic membrane implant degraded and a transparent liquid space existed under the seleral flap in all the rabbits at post operative 12 weeks. Conclusion Amniotic membrane can reduce proliferation of fibroblasts and scar tissue in nonpenetrating trabecular surgery.