MMC对兔眼滤过道成纤维细胞活性的抑制作用

目的：应用细胞增殖指标核仁组成区相关嗜银蛋白（AgNORs),研究兔眼滤过道成纤维细胞（Fb)增殖规律及丝裂霉素C（MMC）的抗增殖作用,并对其临床意义进行探讨。方法：邓兔眼滤过道切片作AgNORs及HE染色,比较MMC眼和对照眼Fb AgNORs染色颗粒数量。结果：不同手术区MMC眼Fb AgNORs颗粒数显著低于对照眼,MMC抑制率为50.7%-82.1%。结论：丝裂毒素C可以有效抑制咬切口、巩膜瓣下、结膜瓣下Fb的增殖活性,抑制作用稍强于同类药物5-Fu。     

羊膜对兔眼滤过道成纤维细胞活性的抑制作用

目的:应用细胞增殖指标核仁组成区相关嗜银蛋白(AgNORs),研究兔眼滤过道成纤维细胞(Fb)增殖规律及羊膜的抗增殖作用,并对其临床意义进行探讨。方法:模仿人眼滤过手术方式行兔眼巩膜瓣下巩膜咬切术,切开前房前巩膜瓣下植入5mm×6mm大小的羊膜,术后1,2,3,4wk取兔眼滤过道标本,作AgNORs及HE染色,比较羊膜眼和对照眼FbAgNORs染色颗粒数量、眼压、滤过泡变化。结果:不同手术区羊膜眼FbAgNORs颗粒数显著低于对照眼,羊膜抑制率为10.8%～59.5%,羊膜眼眼压低于对照眼,术后3,4wk差异有显著性;羊膜眼滤过泡保持时间1～4wk,对照眼为1～2wk。结论:羊膜可以有效抑制滤过道Fb的增殖活性、延长眼压下降和滤过泡保留时间。     

三氧化二砷对成纤维细胞抑制作用的研究

目的应用细胞增生指标核仁组成区相关嗜银蛋白（argyrophilic nucleoar organ-izer regions granules,AgNORs）,观察兔眼滤过道成纤维细胞（fibroblast,Fb）增生规律及三氧化二砷（arsenic trioxide,As2O3）的抗增生作用。方法48只兔随机分为对照组与实验组,实验组根据As2O3的浓度不同分为0.5μmol·L^-1、5μmol·L^-1、10μmol·L^-13组。行常规青光眼小梁切除术,实验组于巩膜瓣制成后将浸泡过As2O3的棉片置于巩膜瓣与巩膜床之间。4组均于术后第3天、第7天、第15天、第30天分别用气栓法处死动物各3只,取兔眼滤过道切片做AgNORs染色及HE染色,比较As2O3实验组眼与对照组眼咬切口、巩膜瓣下及结膜瓣下Fb AgNORs染色颗粒数量。结果不同手术区As2O3眼AgNORs颗粒数明显低于对照眼,其抑制率与浓度呈正相关。5μmol·L^-1组As2O3抑制率在术后第7天可以达到81.13%.结论5μmol·L^-1As2O3即可以有效抑制咬切口、巩膜瓣下及结膜瓣下Fb的增生活性,且未见明显的眼内毒性反应。     

5—Fu抑制兔眼滤过术后成纤维细胞的AgNORs表达

应用细胞增殖指标ＡｇＮＯＲｓ,研究兔眼滤过道成道成纤维细胞增殖规律及５－Ｆｕ的抗增殖作用。方法取兔眼滤过道切片作ＡｇＮＯＲｓ及ＨＥ染色,比较５－Ｆｕ眼和对照眼,ＦｂＡｇＮＯＲｓ染色颗粒数量。结果对照眼滤过道的咬切口,巩膜瓣下,结膜瓣下均有Ｆｂ增殖,且增殖活性第７天最高,第３０天最低。     

兔眼滤过性手术中植入硅凝胶膜的实验研究(英文)

目的:在兔眼行硅凝胶膜植入后,通过观察眼内压、滤过泡、病理组织检查结果评价硅凝胶膜植入的安全性和有效性。方法:共40只兔随机分为4组,每组10只。每只兔一眼行巩膜瓣下小梁咬切术,术中植入硅凝胶膜,对侧眼单纯行巩膜瓣下小梁咬切术作为对照。术后观察眼内压、滤过泡的变化,并且每只眼行组织病理学检查。结果:植入眼较对照眼低眼压和滤过泡维持时间长,光镜显示植入眼滤过道、咬切口区保持通畅。成纤维细胞增殖的活性与规律,在植入眼和对照眼是相似的。硅凝胶膜不会刺激成纤维细胞增殖的过度表达。结论:硅凝胶膜植入术作为一种新型引流术具有安全、有效、操作简单的优点。     

兔眼滤过性手术中植入硅凝胶膜的实验研究

目的：在兔眼行硅凝胶膜植入后，通过观察眼内压、滤过泡、病理组织检查结果评价硅凝胶膜植入的安全性和有效性。 方法：共40只兔随机分为4组，每组10只。每只兔一眼行巩膜瓣下小梁咬切术，术中植入硅凝胶膜，对侧眼单纯行巩膜瓣下小梁咬切术作为对照。术后观察眼内压、滤过泡的变化，并且每只眼行组织病理学检查。 结果：植入眼较对照眼低眼压和滤过泡维持时间长，光镜显示植入眼滤过道、咬切口区保持通畅。成纤维细胞增殖的活性与规律，在植入眼和对照眼是相似的。硅凝胶膜不会刺激成纤维细胞增殖的过度表达。 结论：硅凝胶膜植入术作为一种新型引流术具有安全、有效、操作简单的优点。     

可降解聚合微球持续释放5-氟脲嘧啶作为滤过手术的辅助治疗

目的:研究 5 Fu高分子微球对实验性质滤过术后瘢痕形成的疗效及毒性。方法 :对 40只兔行巩膜后唇咬切术 ,实验组术中结膜下注射 1ml 5 Fu微球 ,对照组术中结膜下注射 2 5 % 5 Fu注射液 10mg。结果 :术后实验组和对照组眼内压和滤过泡的存留有显著性差异。 5 Fu微球药物浓度变化范围 2 6 47～ 9 872ug/ml,持续 14天 ,可降低它的毒性 ,组织学显示两组纤维增生有显著差异。结论 :PTL EO PLA聚合微球通过释放 5 Fu ,防止瘢痕增殖引起的滤过不畅 ,降低 5 Fu的毒性 ,提高兔眼滤过术的成功率 ,有临床应用价值     

无结膜切口的巩膜瓣下咬切术的远期效果观察

目的探讨无结膜切口的巩膜瓣下咬切术的远期疗效。方法用无结膜切口的巩膜瓣下咬切术治疗原发性青光眼10例11只眼。介绍了手术技巧和注意事项．结果经12～24个月随访，效果良好，眼压和滤过泡与对照组相比，远期效果有显著性差异（P＜0．05），术后无明显并发症。结论无结膜切口的巩膜瓣下咬切术能最大限度地减少手术对结膜和结膜下组织的损伤和刺激，减少或消除术后疤痕形成，明显提高手术成功率。     

高三尖杉酯碱脂质体及高三尖杉酯碱 注射液对兔滤过术的作用

目的研究高三尖杉酯碱（ｈｏｍｏｈａｒｉｎｇｔｏｎｉｎｅ,ＨＨＴ）脂质体及高三尖杉酯碱注射液对兔滤过术后抗瘢痕形成的疗效及毒性。方法对４０只家兔双眼行巩膜后唇咬切术,自术后次日起,第１组结膜下注射ＨＨＴ脂质体,第２组结膜下注射空白脂质体（对照组）,第３组结膜下注射低剂量ＨＨＴ注射液,第４组结膜下注射生理盐水（对照组）,第５组结膜下注射高剂量ＨＨＴ注射液。结果２个对照组的滤过泡在术后７天失败,低剂量ＨＨＴ组的滤过泡在术后９天失败,ＨＨＴ脂质体组的滤过泡在术后１２天失败,高剂量ＨＨＴ组的滤过泡在术后１５天失败。术后５～１０天,高剂量ＨＨＴ组的巩膜瘘道阻塞率为３７５％,其余４组的阻塞率均为１０００％;术后１５～３０天,５组的巩膜瘘道阻塞率均为１０００％。高剂量ＨＨＴ组中６３０％的眼出现中至重度角膜水肿及角膜血管翳。结论对兔眼滤过术后应用ＨＨＴ脂质体和低剂量ＨＨＴ注射液不能明显提高兔眼滤过术的成功率。应用高剂量ＨＨＴ注射液可暂时提高兔眼滤过术的成功率,但副作用亦明显增加。     

冻干羊膜在抗青光眼术中应用的初步报告

目的　观察冻干人羊膜在抗青光眼手术中的防粘连作用。方法　对 10例 (13只眼 )难治性青光眼行小梁切除术后 ,在巩膜瓣及结膜瓣下植入冻干羊膜。结果　术后第 1天结膜下滤过泡扁平 ,前房形成良好。术后 3个月结膜下滤过泡无明显变化。术后第 1天及术后 3个月平均眼压为 14 .3± 2 .5 mm Hg及 15 .9± 1.8m m Hg,与术前相比有显著性差异 (P <0 .0 0 1)。结论　冻干羊膜具有防粘连、保持滤过道通畅的作用。     

青光眼术后滤过区生长因子的表达及干扰素拮抗生长因子作用的初步研究

目的探讨青光眼术后滤过区局部生长因子的表达及干扰素α-2b(interferon alpha-2b,IFNα-2b)在体内环境下对b成纤维生长因子(beta-Fibroblastic Growth Factor,bFGF)、转化生长因子β1(Transforming Growth Factor beta1,TGFβ1)的作用.方法采用冰冻切片的免疫组化染色技术.标本取白兔眼行巩膜咬切术后的滤过区组织,实验分为正常对照组和用药组两组,各4只兔8只眼.全部兔眼局麻下行标准统一的巩膜咬切手术.用药组于术后当时、术后隔天接受滤过区旁结膜下注射干扰素α-2b 5×105 IU 0.2ml各1次,正常对照组不用药.分别检测术后第3、5、7、14d滤过区标本内bFGF、TGFβ1抗原的表达.结果正常对照组标本中,术后3d的滤过区细胞问质已能检测出bFGF或TGFβ1阳性表达产物及阳性细胞;第5至7d达到高峰;第14d的明显减少.用药组的标本中,表达两种生长因子的物质和细胞显著减少.结论抗青光眼术后手术区局部"沐浴"着生长因子,术后伤口愈合的发生有bFGF、TGFβ1生长因子的参与.而INFα-2b体内环境下具有拮抗bFGF、TGFβ1的作用.眼科学报2001;17106～110.     

Laser and unsutured sclerotomy in nanophthalmos

Among 30 eyes with nanophthalmos, 21 had angle-closure glaucoma and two had open-angle glaucoma associated with pseudoexfoliation of the lens capsule. Laser iridotomies, sometimes combined with laser iridoplasty, were sufficient to control, or to allow medical control of, the glaucoma in 15 of 18 eyes. Four eyes with uveal effusion underwent an unsutured sclerotomy or sclerectomy, and all had resolution of the choroidal detachment within two weeks. Cataract extraction improved the vision in seven of nine eyes. Previous or simultaneous sclerotomy or sclerectomy was performed on all nine eyes that underwent cataract extraction and in two eyes at the time of glaucoma surgery; no eye had postoperative uveal effusion or other major complications. Laser iridotomy and iridoplasty, sometimes with supplemental medical therapy, are often sufficient in the treatment of angle-closure glaucoma in nanophthalmos and are safer than surgery. Nanophthalmic uveal effusion can be prevented or treated with an unsutured sclerotomy or sclerectomy.     

5—氟尿嘧啶高分子缓释剂在兔眼滤过术后抗瘢痕形成的研究

目的研究５－氟尿嘧啶（５－ｆｌｕｏｒｏｕｒａｃｉｌ，５－Ｆｕ）缓释剂在兔眼滤过术后抗瘢痕形成的疗效及毒性。方法对２３只家兔双眼行巩膜后唇咬切术，术后次日第１组结膜下注射２．５％５－Ｆｕ缓释剂１０ｍｇ，第２组结膜下注射２．５％５－Ｆｕ注射液１０ｍｇ。术后第１周隔日用药１次，连续３次；第２周隔２日用药１次，连续３次。第３组用同法注射等体积的空白缓释剂。结果空白缓释剂组的滤过泡在术后７天内失败，５－Ｆｕ注射液组的滤过泡在术后２０～３０天失败，５－Ｆｕ缓释剂组的滤过泡持续至实验全程。术后７～３０天，５－Ｆｕ缓释剂组巩膜瘘道的阻塞率为６．７％，５－Ｆｕ注射液组为４１．７％，空白缓释剂组为１００．０％。５－Ｆｕ缓释剂组３只眼，５－Ｆｕ注射液组８只眼及空白缓释剂组２只眼出现角膜上皮缺损。结论本研究结果显示，５－Ｆｕ缓释剂可有效防止滤过泡瘢痕化及巩膜瘘道阻塞，提高兔眼滤过术的成功率，并降低５－Ｆｕ注射液的毒性，有临床应用价值。     

Role of chymase on growth of cultured canine Tenon's capsule fibroblasts and scarring in a canine conjunctival flap model

Chymase is a chymotrypsin-like serine protease contained in the secretory granules of mast cells. Recently, we reported that chymase activity and the number of chymase-positive mast cells in conjunctival tissues were significantly increased during the wound healing process in a hamster model of glaucoma surgery. However, it has been unclear the role of chymase on conjunctival scarring. In the present study, we evaluated the effect of dog chymase on cell proliferation of fibroblasts established from canine Tenon's capsule and the effect of a chymase inhibitor on scarring in a canine conjunctival flap model. After a fibroblast cell culture was established from canine Tenon's capsules, the fibroblasts were incubated in the presence of dog chymase (5-20 ng ml(-1)). Cell proliferation was evaluated by bromodeoxyuridine incorporation. In a canine conjunctival flap model, a sponge treated with a chymase inhibitor, Suc-Val-Pro-Phe(P)(OPh)(2), or placebo was placed in between the conjunctiva and sclera and the conjunctival incision was closed. One week after the surgery, adhesion degree was assessed, and chymase activities in the conjunctival lesion and in the areas of the conjunctiva and sclera were measured. In cultured canine Tenon's capsule fibroblasts, dog chymase significantly increased cell proliferation, and this chymase-dependent proliferation was completely suppressed by the chymase inhibitor. In the canine surgical model, chymase activity in placebo-treated eyes was significantly increased compared to control eyes, while it was significantly decreased by treatment with the chymase inhibitor. Scores for adhesion degree in the chymase inhibitor-treated eyes were significantly decreased in comparison with those in placebo-treated eyes. The conjunctival area in the chymase inhibitor-treated eyes was also suppressed to 52.6% compared with that in placebo-treated treated eyes. In conclusion, chymase stimulates proliferation of fibroblasts derived from canine Tenon's capsule and chymase may play an important role in scarring after glaucoma surgery.     

Different Effects of Topical Prazosin and Pilocarpine on Uveoscleral Outflow in Rabbit Eyes

Purpose:To investigate the effects of topical prazosin and pilocarpine on uveoscleral outflow(Fu) in rabbits.Methods:Sixteen rabbits were randomly divided into the control group (5 rabbits, only topical application of normal saline in the fight eye of each rabbit), Prazosin (PZ) treated group (6 rabbits, only 0.1％ Prazosin eyedrop 0.1％ in the right eye of each one) and Pilocarpine (PC) treated group (5 rabbits, 1％ Pilocarpine eye drop in each fight eye). Intraocular pressure (IOP) of bilateral eyes of each rabbit was measured before and 1h after topical application of the eye drop. And the bilateral eyes were perfused with Fluorescein-isothiocyanate bovine serum albumin (FITC-BSA) as the tracer into the anterior chamber of each rabbit for 30 min at 90 min after topical treatment. Then the rabbits were killed for Fu measurement.Results:IOP of PZ-treated eyes decreased [(0.71±0.07)kPa] in 1 hour after PZ application. IOP of PC-treated eyes decreased [(0.70±0.08)kPa] in 1 hour after PC application. Th     

Influence of deep scleral flap size on intraocular pressure after deep sclerectomy

PURPOSE: To study the effect of several morphometric characteristics of the deep scleral flap on intraocular pressure (IOP) control after deep sclerectomy. METHODS: The authors conducted a nonrandomized prospective study of 56 eyes of 51 patients who underwent deep sclerectomy alone or combined with phacoemulsification. A reticulated hyaluronic acid implant was used in all cases. The surface, volume, and weight of the dissected deep scleral flap were measured and recorded. The correlation between these parameters and the postoperative IOP was evaluated at 6 and 12 months postoperatively. RESULTS: Forty-nine eyes (87.50%) achieved an IOP of 21 mmHg or less without treatment, and the need for medication was decreased significantly (p<0.001) at 12 months postoperatively. The authors found a significant inverse correlation between the mean postoperative IOP at 6 months and the surface, volume, and weight of the deep scleral flap, but not at 12 months postoperatively. CONCLUSIONS: Greater weight, surface area, and volume of the deep scleral flap dissected during deep sclerectomy achieve significantly lower postoperative IOPs in the early postoperative period.     

Deep sclerectomy in congenital glaucoma. Preliminary results]

PURPOSE: Trabeculectomy is an efficient procedure for congenital glaucoma, but can lead to postoperative complications. These complications seem to be less frequent with deep sclerectomy. The aim of this study is to evaluate results of this surgical technique for congenital glaucoma. MATERIALS AND METHODS: Twelve eyes from eight patients (age 2 to 84 months) with congenital glaucoma underwent sclerectomy and were followed-up for 10 months postoperatively. Success criteria was intraocular pressure inferior to 16 mm Hg under general anaesthesia. RESULTS: No per or immediate postoperative complication was observed. For nine eyes (75%), intraocular pressure was controlled at final examination. For three eyes, postoperative intraocular pressure was elevated and one of them underwent re-operation. CONCLUSIONS: Success rate of sclerectomy for congenital glaucoma is equivalent to trabeculectomy. Absence of anterior chamber opening diminishes postoperative complications risk. Further study with longer follow-up is currently under evaluation.     

脉络膜渗漏综合征的眼底血管造影特征

目的 观察脉络膜渗漏综合征(UES)的眼底血管造影特征。 方法 回顾分析UES患者11例17只眼荧光素眼底血管造影（FFA）及吲哚青绿血管造影（ICGA）检查的临床资料。其中7只眼在作巩膜板层切除手术后1~28个月再行造影检查。 结果 FFA及ICGA检查显示12只眼有视网膜静脉纡曲扩张及视盘水肿，2只眼在后极部出现荧光素渗漏点，14只眼有豹纹样色素斑(豹斑)，8只眼有线条状或网状色素条纹。ICGA检查4例5只眼的斑片状强荧光一直持续至晚期，1只眼在眼底下方有三角形弱荧光区，1只眼在后极部显示地图状弱荧光区。巩膜板层切除手术后患眼睫状体脉络膜脱离逐渐好转甚至消失，脉络膜高灌注状态改善，渗漏点消失。1只眼手术2年后视网膜下液又增多。 结论视网膜静脉纡曲扩张及视盘水肿、豹斑和线条状或网状色素条纹是UES的特征性眼底血管造影表现；这些表现有助于加深对此病的理解和临床诊断。(中华眼底病杂志，2007，23：189-192)     

Nonpenetrating deep sclerectomy versus trabeculectomy in bilateral primary open-angle glaucoma

OBJECTIVE: To establish the efficacy and safety of nonpenetrating deep sclerectomy versus trabeculectomy in primary open-angle glaucoma. DESIGN: Prospective randomized trial. PARTICIPANTS: Thirty-nine patients (78 eyes) with bilateral primary open angle glaucoma were included in the study. INTERVENTION: Eyes were randomly assigned to receive deep sclerectomy in one eye and trabeculectomy in the other eye. MAIN OUTCOME MEASURES: Mean intraocular pressure (IOP), postoperative medications, visual acuity, success rate, and complications. RESULTS: At 12 months, mean IOP reduction was 12.3 +/- 4.2 (sclerectomy) versus 14.1 +/- 6.4 mmHg (trabeculectomy) (P = 0.15), and an IOP 相似文献