非穿透性滤过手术联合羊膜移植的实验研究

Non-penetrating filtering surgery with amniotic membrane transplantation in rabbits

探讨羊膜移植在兔眼非穿透性滤过手术中的抗瘢痕化作用及其毒副作用。方法 :选取新西兰白兔 15只 ,双眼行非穿透性滤过手术 ,术中随机选取一眼联合羊膜移植。术后观察术眼眼内反应、滤过泡形态和功能 ,并行角膜内皮活性染色、眼球组织切片及滤过区组织学检查。结果 :实验组术后第 10天时 ,全部术眼可见弥散隆起的滤过泡 ,第 14天时 ,滤过泡存留有 6眼 ;对照组术后 5～ 7天开始出现滤过区局限 ,第 10天时仅有 3眼存留滤过泡 ,第 14天仅有 1眼 ,差异有统计学意义。实验组组织学检查显示滤过区纤维组织形成少 ,但局部有炎症细胞浸润。对照组滤过区见大量纤维瘢痕组织形成。所有术眼前房反应轻微 ,角膜内皮活性染色及眼球组织切片未见异常。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 ,且对兔眼组织无毒副反应。

Objective:To evaluate the values of amniotic membrane transplantation in rabbit non-penetrating filtering surgery. Methods:Thirty eyes of 15 rabbits were undergone non penetrating filtering surgery.Fifteen eyes were combined with amniotic membrane transplantation under the scleral flap,while the other 15 eyes did not.The results from the two groups were compared on filtering bleb formation,histological exams,intraocular reaction and corneal endothelial activity staining at postoperative day 7 and 14,respectively. Results:No significant conjunctival reaction and anterior chamber reaction were seen after surgery.No sign of damage were observed in corneal endothelium,lens and retina.The number of eyes with functional filtering bleb was more in experiment group than that in control group.There were more fibroblasts and scar tissue in filtering area in control group under the light microscope. Conclusions:Amniotic membrane could reduce proliferation of fibroblasts and scar tissue in non penetrating filtering surgery,and no significant side effect was seen in rabbits.