青光眼滤过手术中抗代谢药物促滤泡形成的实验研究

Experimental study of promoting filtration bleb with antimetabolites on glaucoma filtering surgery

目的 :探讨兔眼滤过手术中抗代谢药物促滤泡形成的作用。方法 :用巩膜咬切器对 79只实验兔( 15 8眼 )实施全层巩膜切除术 ;用二氧化碳激光对 14只实验兔 ( 2 8眼 )实施了经外路巩膜造口术。术中一次用红比霉素或阿克拉霉素处理切口的分别为 45眼和 3 5眼 ,术后结膜下注射 5 -FU针剂为 3 6眼 ,注射 5 -FU高分子缓释剂为 16只眼 ,其余 5 4眼为对照眼。术后定期观察眼前节 ,测量眼压。结果 :浓度为 0 4mg/ml的红比霉素和阿克拉霉素术中一次应用效果较好 ,结膜下注射 5 -FU高分子缓释剂较 5 -FU针剂效果好 ,副作用小。 5 -FU结膜下注射可延长激光巩膜造口术的成功率。结论 :适量的抗代谢药物术中或术后应用有利于兔眼滤过手术后滤泡的形成。

Objective:?To explore the effect of promoting filtration bleb with antimetabolites in rabbits. Methods:Sclerectomy was performed in 79 rabbits (158 eyes) using a scleral punch and ab-externo sclerostomy was performed in 14 rabbits (28 eyes) using a carbon dioxide laser. 45 and 35 eyes were treated respectively with daunorubicin and aclacinomycin intraoperatively. 36 and 16 eyes were given respectively subconjunctival injection of 5-FU or 5-FU polymer postoperativly. Another 54 eyes were allocated to the control groups. After the operations intraocular pressure and the anterior segment of the eye were assessed regularly. Results:?Daunorubicin or aclacinomycin at a dose of 0.4 mg/ml had better effect promoting filtration bleb. 5-FU polymer had better effect and less complications than 5-FU. Success of laser sclerostomy could be increased and prolonged by subconjunctival injection of 5-FU postoperativly. Conclusion:?Using appropriate antimetabolites intra or postoperativly is beneficial to promoting filtration bleb in rabbits.