抗青光眼术中应用C_3F_8的滤过泡形态学实验研究

The application C3F8 gas in filtering surgery

目的:研究C3F8气体引起滤过泡的性状、功能、结构变化,探讨C3F8气体辅助应用于抗青光眼滤过术中的作用机理。方法:通过动物实验研究,观察C3F8气体辅助应用于兔眼小梁切除术后3天、1周、2周、3周、4周滤过泡的性状、功能和眼压,并进行病理组织学检查。结果:①眼压:C3F8气体组和单纯小梁切除术组术后3天、2周、3周的眼压差异均有统计学意义;C3F8组和MMC组术后3天的眼压差异有统计学意义;②滤过泡大小:C3F8气体组和单纯小梁切除术组术后3天差异有统计学意义;C3F8气体组五个时期比较,其中术后3天和1周、3天和2周、3天和3周、1周和2周、1周和3周的差异均有统计学意义。③有功能滤过泡的数量:C3F8气体组和MMC组术后3天均为100％;单纯小梁切除术组术后2周无;而C3F8气体组术后4周仍有25％的有功能的滤过泡。④结膜下间隙:光镜检查发现,C3F8气体组和MMC组结膜下均有较大的结膜下间隙,与单纯小梁切除术组之间差异均有统计学意义。结论:小梁切除术中辅助应用C3F8气体可以保持巨大的结膜下间隙,改善滤过泡的形态和体积,提高滤过泡的存活率;且比单纯小梁切除术能更有效的降低眼压。

Objective: To study the changes in morphology and function of filtering blebs, and in intraocular pressure (IOP) and subconjunctivalspace of rabbit eye with C3F8 application in trabeculectomy.Methods: IOP, morphology and volume of filtering blebs of rabbit trabeculectomy with subconjunctival retention C3F8 gas were observedon postoperative day 3, 7, 14, 21 and 24 respectively. The conjunctiva and sclera of filtering area of the rabbits were taken histopatholo-gic examination.Results: The mean IOPs of simple trabeculectomy group and C3F8 gas group on postoperative day 3, 14, 21 were significantly different;the mean IOPs of C3F8 group between day 3 and day 14 were also significantly different. The mean volume of filtering blebs between twogroups on day 3 was significantly different; the mean volumes of C3F8 group among days were significantly different. The difference innumbers of functional bleb between the above two groups was significant, but between C3F8 group and MMC group was not significant.There was no functional bleb in trabeculectomy group from day 14 to 24. The differences in subconjunctival space between simple groupand the rest two groups were significant; but the difference between C3F8 group and MMC group was not significant.Conclusions: The morphology, volume of filtering blebs, IOP, subconjunctival space, and numbers of functional could be improved withgas application than simple trabeculectomy.