羊膜植入对兔眼仿青光眼术后滤过区瘢痕影响的实验研究

Effects of transplantation of amniotic membrane on synulosis of the filtering area following resemble trabeculectomy in rabbit eyes

[目的]探讨羊膜植入对仿青光眼滤过术后滤过区瘢痕形成的影响。[方法]36只（72眼）健康新西兰白色塔兔,随机分为3个处理组：全麻下施行小梁切除术联合羊膜植入（A组）,小梁切除术联合丝裂霉素C（MMC）（B组）,单纯小梁切除术（C组）。观察各组术后不同时间眼压、滤过泡及滤过区瘢痕形成及组织内碱性成纤维细胞生长因子（bFGF）的表达情况。[结果]A、B组术后14 d的滤过区组织bFGF表达,阳性细胞很少,阳性物质分布稀疏,少见或未见成纤维细胞及纤维细胞,而C组在3 d就可以在滤过区看到大量bFGF表达,阳性细胞及bFGF物质的表达逐渐增多,到7 d达到高峰,到14 d已见不到成纤维细胞增殖,完全被纤维组织取代;A、B与C组功能性滤过泡所占比例分别为95.8%、100%与79.1%（P〈0.05）;A、B组术后眼压平稳波动于13-18 mmHg并较术前18-23 mmHg略低,P〈0.05。[结论]羊膜通过抑制滤过区巩膜瓣下bFGF的表达,可对青光眼滤过术后滤过区瘢痕的形成起到抑制作用。

[ Objective ] To explore the effects of transplantation of amniotic membrane on synulosis in the filtering area following resemble trabeculeetomy. [ Methods ] Thirty -six white anosia rabbits （72 eyes） were divided into three groups randomly： the trabeculectomy with transplantation of amniotic membrane（ A）, the trabeculectomy with treatment of mitomycin （B） and trabeculectomy （C）. Intraocular pressure （ lOP）, filtration blebs, synulosis and the expression bFGF in the filtration area tissue were examined at different time after the surgery. [ Results ] In the group A and B, the cells showing positive reaction to bFGF were few and positive substance distributed sparsely in the filtering area at the 14th day after operation. Few fibroblasts and fibrosis cells were seen. But in the group C, a lot of positive cells for bEGF were seen in the filtering area at the 3rd day; the number of these cells reached to the peak at the 7th day. No proliferation of fibroblast was found instead of the fibrosis completely on the 14th day. The proportion of functional filtation blebs for group A, B and C were 95.8% ,100% and 79.1%, respectively（P 〈0.05）. The range of IOP for group A and B was stable between 13 and 21 millimetres of mercury, lower than that before operation between 18 and 23 millimetres of mercury （P 〈 0.05 ）. [ Conclusion ] Transplantation of amniotic membrane may inhibit the activity of fibroblast after trabeculectomy can be restrained.