摘要
目的观察抗代谢药丝裂霉素C（MMC）对家兔小梁切除术后滤过泡瘢痕化的干扰效应。方法对15只家兔双眼实行小梁切除术，左眼应用含0．2mg／mLMMC的棉片接触瓣下巩膜床4min，右眼为PBS对照组；2只家兔为正常对照组。术后第1、3、7、14、30、60d测量眼压，术后第3、7、14、30、60d分批处死家兔，摘除双眼，做组织病理学观察，计算机图像分析胶原量。结果PBS组滤过术后胶原纤维增生术后3～14d为高峰期，眼压至术后14d恢复正常（P〉0．05）。术后第1d右眼术区滤过泡形成，7d后平复，滤过通道在第7d关闭，应用MMC眼术后纤维增生不明显，眼压在第60d恢复正常眼压（P〉0．05）。术后通常第3d左眼术区滤过泡形成，14d后平复，滤过通道在第60d左右关闭。术后7d内MMC造成2只眼感染，6只眼结膜切口渗漏，5只眼角膜水肿混浊。结论丝裂霉素能长久有效地控制眼压，拮抗术后结膜下和滤过道瘢痕形成，但不良反应明显，应谨慎使用。
Objective Our study aimed to investigate the histology alteration of filtering passageway and its influence on intraocular pressure and filtering bleb in the eyes with trabeculectomy in rabbit. Methods Trabeculectomy was performed on both eyes of 15 rabbits,and then cotton film with 0.01 mol/L PBS was placed under the sclera flap of right eyes of rabbits for 4 minutes and 2 mg/mL MMC was used on the left eyes in the same way. Intraocular pressure was measured on the 1st, 3rd,7th, 14th,30th and 60th day. Animals were executed in batch and both eyes were enucleated for morphology study in above time points after trabeculectomy under the light microscope. The quantitative analysis of Mallory staining was curried out with computer image analysis system. Results The intraocular pressure in MMC group was significantly reduced in the 3rd,7th,14th and 30th day in comparison with PBS group（ P 〈 0. 05 -0. 01 ）. Mallory staining area for collagenous fibers was considerablly increased in PBS group compared with MMC group in the 3rd to 14th day and kept stable until the 30th day after filtering operation（ P 〈 0. 05 - 0.01 ）. The intraocular pressure returned to normal level on the 14th day and the filtering passageway closed on the 7th day in PBS group,however,the intraocular pressure returned to the normal level on the 60th day and filtering passageways closed until the 60th day. The complications of MMC included infestation in 2 eyes,leakage of aqueous humor at conjunctival incision in 6 eyes and corneal edema in 5 eyes. Conclusion There has an outstanding correlation between collogen proliferation and intraocular pressure after trabeculectomy. It is the critical reason that the cicatricle leads to operative failure at earlier period,but the collapse of filtering passageway is probable the reason of operative failure at long-term. MMC can reduce cicatriele in filtering passageway and subconjunctiva,but special attention should be payed to its serious side effect.
出处
《眼科研究》
CSCD
北大核心
2008年第4期258-261,共4页
Chinese Ophthalmic Research
关键词
小梁切除术
丝裂霉素C
眼压
滤过泡
trabeculectomy
mitomycin C
intraocular pressure
filtering bleb
