选择性激光小梁成形术对小梁网显微结构影响及降压机制研究

Study on the effect of selective laser trabeculoplasty on microstructure of trabecular meshwork in rhesus monkey and possible action mechanism of lowering intraocular pressure

目的实验观察选择性激光小梁成形术(SLT)对猕猴小梁网显微结构的作用。方法健康成年恒河猴8只8眼,无眼疾,房角为开角。右眼上方180°行SLT,左眼作对照眼,术后1周,双眼行小梁切除术,做扫描电镜和透射电镜观察,自身对照SLT治疗前后小梁组织的形态学改变。结果 SLT术后弥猴眼小梁组织扫描电镜见小梁网结构完整,小梁柱层次清楚,未见凝固性损伤及热损伤,只有局部小梁架的裂隙样改变,小梁网间隙中可见较多体积较大的吞噬细胞;透射电镜见色素性小梁内皮细胞内可见部分黑色素颗粒崩解、外溢。结论 SLT对小梁组织无凝固性损伤及热损伤,可以重复治疗。

Objective To observe the effect of selective laser trabeculoplasty （SLT） on microstructure of trabecular meshwork in rhesus monkey through experimental study. Methods The 8 eyes,without any infection,of 8 adult healthy rhesus monkeys were enrolled in this study. SLT was performed at upper 180° of the right eyes,the left eyes were used as control eyes. Trabeculectomy of both eyes was performed after one week. Morphological changes of trabecular meshwork were observed by scanning electron microscope and transmission electron microscope with own control before and after SLT. Results The results by scanning electron microscope observation showed that at one week after SLT the ocular trabeculum of rhesus monkey had clear layers, local mechanical injury （fissure-liking change） and many large phagocytes among trabecular meshwork, furthermore, without eoagulability injury and heat injury. By transmission electron microscope observation,the disintegration and leakage of some melanin granules could be found in pigment endothelial ceils of trabeculum. Conclusion SLT does not induce coagulability injury and heat injury of trabecular meshwork, so which can be applied repeatedly.