结膜松解切口与前移修复晚期滤过泡渗漏

目的评价结膜松解切口与前移修复晚期滤过泡渗漏的效果。方法对19只眼小梁切除术后晚期滤过泡渗漏进行前瞻性连续病例研究。17例（19只眼）术后晚期出现滤过泡渗漏,且伴有浅前房及低眼压。结果17眼滤过泡修复术后2％荧光素Seidel试验检查滤过泡处无房水渗漏且滤过泡功能良好。修复术前平均眼压为（8．06±3．9）mmHg,术后平均眼压为（16．6±2．5）mmHg（1mmHg=0．133kPa）,（t=23．17,P〈0．001）。术后随访15～18月,17跟（89．5％）获得大体成功,14只眼（73．7％）为完全成功。2只眼（10．5％）失败。术后未出现严重的浅前房、低眼压。3只眼需要继续应用降眼压药物,2只眼因滤过泡处渗漏需再次手术。结论结膜松解切口与前移修复晚期滤过泡渗漏是安全有效的。     

小梁切除术不同结膜瓣滤过泡的形成分析

目的：探讨小梁切除术两种不同结膜瓣术后功能性滤过泡形成情况。方法：比较372例（372只眼）原发性青光眼不同结膜瓣小梁切除术术后功能性滤过泡形成情况，其中以角巩缘为基底的结膜瓣165只眼，以穹窿部为基底的结膜瓣207只眼。结果：术后1周对所有患者进行了观察，3个月时只有127只跟进行了随访。以角巩缘为基底的结膜瓣手术组术后1周滤过泡成功率为83．03％，3个月时为78．69％。以穹窿部为基底的结膜瓣手术组术后1周滤过泡成功率为55．07％，3个月时为53．03％。两组比较有明显差别。结论：本组研究发现，传统的以角巩缘为基底的结膜瓣术后滤过泡成功率高于以穹窿部为基底的结膜瓣，其术后降压效果相应亦较好。     

兔眼滤过术中结膜瓣下辅助应用全氟丙烷后滤过道的组织病理学变化

目的研究小梁切除术中辅助应用全氟丙烷(C3F8)气体后滤过道的组织病理学变化.方法对20只新西兰兔实施小梁切除术.随机分为两组,每组各10只兔(20只眼).第1组随机选择1只眼做单纯小梁切除术,另1只眼做小梁切除术并辅助应用C3F8气体;第2组随机选择1只眼做小梁切除术联合应用丝裂霉素C(MMC),另1只眼做小梁切除术并辅助应用C3F8气体.采用组织病理学和免疫组化技术,对兔眼术后3 d,1、2、3、4周不同时期的滤过泡组织进行病理检查,观察成纤维细胞、新生胶原纤维、新生血管、炎性细胞的改变.结果应用C3F8气体组与单纯小梁切除术组术后滤过道新生胶原纤维量、成纤维细胞量差异均有显著意义(P<0.05);应用MMC组与单纯小梁切除术组术后滤过道新生胶原纤维量、成纤维细胞量差异均有显著意义(P<0.05);应用C3F8气体组与MMC组术后滤过道新生胶原纤维量、成纤维细胞量差异无显著意义(P>0.05).3种不同术式兔眼术后滤过道的新生血管量与术后5个不同时期滤过道的炎性细胞量进行比较,差异均无显著意义(P>0.05).结论小梁切除术中辅助应用C3F8气体可以在术后早期抑制成纤维细胞增殖和新生胶原纤维的合成,抑制或减轻术后滤过道的瘢痕化,从而提高手术的成功率.     

青光眼复合式小梁切除术后浅前房原因及治疗

目的分析青光眼复合式小梁切除术后浅前房发生的原因和治疗效果。方法回顾性分析我院青光眼复合式小梁切除术后浅前房37例（38眼）的原因及治疗效果。结果青光眼复合式小梁切除术683眼中术后发生浅前房38眼（5．56％）。分析其原因主要为滤过过强18眼,结膜瓣渗漏3眼,脉络膜脱离11眼,睫状环阻塞性青光眼5眼,其他原因1眼。治疗采用的药物：睫状肌麻痹剂、高渗剂、皮质类固醇等和／或手术,包括：结膜瓣修补术,玻璃体抽液联合前房注气术等,32眼经过药物治疗前房形成,6眼药物治疗无效通过手术治疗后前房形成。结论38眼复合式小梁切除术后浅前房84．22％的术后浅前房可以通过药物形成前房,只有15．78％需要手术治疗。     

Protective effect of uridine on cornea in a rabbit dry eye model

PURPOSE: To investigate the effect of uridine on cultured human corneal epithelial cells and keratocytes in vitro and to evaluate whether the application of uridine-containing eye drops could improve ocular surface health in an in vivo dry eye model. METHODS: Uridine was added to cultured epithelial cells (3 x 10(4) cells/well) and keratocytes (1 x 10(4) cells/well) at various concentrations (0.5-50 microM). Cytotoxicity was tested with the use of MTT assay, and the cells were assessed for apoptosis with the use of flow cytometry. Expressions of hyaluronic acid (HA), glycosaminoglycan (GAG), nitric oxide (NO), and matrix metalloproteinase (MMP)-9 were measured. In vivo, the degree of reepithelialization was assessed after topical application of uridine (100 microM) in a rabbit corneal wound model. Changes in tear production and conjunctival goblet cell counts were investigated after instillation of various concentrations of uridine-containing eye drops in a rabbit dry eye model. RESULTS: In vitro, uridine showed no cellular toxicity. It increased the biosynthesis of HA and GAG and reduced MMP-9 levels in cultured corneal epithelial cells and keratocytes. In vivo, uridine enhanced corneal wound healing and significantly increased the number of conjunctival goblet cells in rabbits. CONCLUSIONS: Uridine can restore the health of the ocular surface in a rabbit corneal wound and dry eye model.     

Fibrin glue as a suture substitute: histological evaluation of trabeculectomy in rabbit eyes

PURPOSE: To describe the outcome of the use of fibrin adhesive (Quixil) in penetrating trabeculectomy in a rabbit model. METHODS: Fibrin adhesive was used experimentally to attach the conjunctiva and the scleral flap in two groups of 17 New Zealand albino adult rabbits (34 eyes). In the first experiment (20 eyes), the fibrin adhesive was used to reattach the tissue after conjunctival peritomy and scleral flap only in 14 eyes (experiment I). In 6 eyes (controls), the conjunctiva was attached with nylon sutures. In the second experiment (14 eyes), the fibrin adhesive was used after conjunctival peritomy, scleral flap, and penetrating trabeculectomy in 8 eyes (experiment II). In a control group of 6 eyes, nylon sutures were used to attach the scleral flap and the conjunctiva after penetrating trabeculectomy. Biomicroscopy and histopathological examinations were performed on postoperative days 1, 3, 7, 14, 21, and 30. Intraocular pressure was measured before and after surgery in the second experiment. Main outcome measures are histological presence of adhesive in the tissue, degree of capillary congestion, inflammatory reaction, collagen density [scar formation] and clinical (IOP measurements before and after surgery, conjunctival chemosis, anterior chamber reaction, presence of filtering bleb and wound leakage). RESULTS: In experiments I and II, the adhesive was well identified histologically in the tissue as an amorphic eosinophilic substance for up to day 3 and nearly disappeared by day 7. An acute inflammatory reaction was noted for up to 14 days, which converted to chronic inflammation with collagen deposits and scar formation by day 30. Similar inflammatory reaction was observed in the control group. The adhesive had no adverse effects on ocular tissue compared with sutures. One eye in experiment II demonstrated wound dehiscence. Intraocular pressure dropped from 17.35 mmHg preoperatively to 8.28 mmHg on postoperative day 1 in experiment II, and from 17.2 mmHg to 11.5 mmHg in the controls. No significant change in intraocular pressure was noted in experiment I. CONCLUSIONS: The fibrin adhesive had no adverse effects on ocular tissue compared with sutures. It might serve as an effective substitute for conjunctival and scleral wound closure in trabeculectomy surgery.     

Indocyanine green staining facilitates detection of bleb leakage during trabeculectomy

PURPOSE: To report a new technique to visualize bleb leakage using indocyanine green (ICG) staining during trabeculectomy. PATIENTS AND METHODS: The ICG solution was widely applied over the filtering bleb including the conjunctival wound before completion of trabeculectomy. This procedure was performed in 48 eyes of 44 consecutive patients undergoing trabeculectomy between December 2004 and October 2005. RESULTS: Without staining, bleb leakage was not identified by the direct observation under the operating microscope. ICG staining clearly visualized aqueous leakage from the bleb in 5 eyes (10.4%). The bleb leakage in these eyes was easily repaired with 10-0 nylon sutures, and no eyes, including these 5 cases, showed bleb leakage after surgery. There were no intraoperative and postoperative complications related to ICG application. CONCLUSIONS: The application of ICG during trabeculectomy is a simple and useful technique to facilitate detection and repair of the bleb leakage.     

Hydrodissection of conjunctival flap during trabeculectomy in eyes with conjunctival scarring caused by trachoma

BACKGROUND AND OBJECTIVE: Conjunctival scarring caused by trachoma represents a substantial challenge even to the most experienced cataract/glaucoma surgeon. We describe a simple technique of hydrodissection of conjunctival flap during combined trabeculectomy and phacoemulsification in eyes with conjunctival scarring caused by trachoma, and discuss its impact on surgical outcome. PATIENTS AND METHODS: A prospective study was conducted in 10 Omani patients, aged 48 to 83 who underwent combined trabeculectomy and phacoemulsification with intraocular lens (IOL) implantation. The conjunctival flap was prepared after hydrodissection using a mixture of 1 mL of balanced salt solution (BSS) and 1 mL of lignocaine 2% with 1:200,000 adrenaline. Outcome measures that were evaluated were visual function, intraocular pressure (IOP) and bleb characteristics. Patients were followed-up postoperatively for a minimum period of 6 months. RESULTS: The mean age of patients was 60.4 years (48-83) and a functioning bleb after 6 months was seen in 8 (80%) cases. IOP < 20 mm of Hg (applanation tonometry) without antiglaucoma medications was found in 8 cases; 1 case required one antiglaucoma medication and 1 case required more than one antiglaucoma medication for control of IOP. The latter was reoperated for control of IOP. Nonprogression of visual field was found in 8 (80%) cases. CONCLUSION: Preparation of conjunctival flap by hydrodissection was found to be a simple modification of the conventional technique during combined trabeculectomy and phacoemulsification in trachomatous eyes. It reduced conjunctival dissection, use of cautery and possibility of button-holing of the conjunctiva during dissection in scarred eyes. The minimal tissue dissection involved in this procedure reduced wound healing and thereby increased chances of a functioning bleb, control of IOP and nonprogression of visual field compared to combined surgery employing a conventional method (nonhydrodissection method) of conjunctival flap dissection.     

筋膜下麻醉小梁切除术

目的:探讨筋膜下麻醉行小梁切除术的有效性及安全性。方法:在连续58例(60眼)青光眼小梁切除术中分别应用表面麻醉、球后麻醉、筋膜下麻醉各20眼,观察麻醉效果、并发症情况。结果:表面麻醉组患者术中在上直肌牵引缝线、巩膜电凝、周边虹膜切除、结膜缝合时有不同程度痛感,筋膜下麻醉、球后麻醉组患者术中无明显痛感,筋膜下麻醉组1眼、球后麻醉组2眼术中出现一过性黑矇,球后麻醉组术中出现球后出血1眼,术后短暂性上睑下垂2眼。结论:小梁切除术采用筋膜下麻醉具有麻醉效果好、并发症少的优点,是理想麻醉方法。     

兔眼SBK、LASIK、PRK术后角膜转化生长因子β、α-平滑肌肌动蛋白的表达及创口愈合机制的对比研究

背景 目前对飞秒激光前弹力层下角膜磨镶术(SBK)术后创面愈合的研究较多,关于新型角膜板层刀SBK方面的研究尚少.观察术后早期成纤维细胞的活化程度,可以了解术后不同时间的角膜细胞增生情况. 目的 检测转化生长因子(TGF-β)和α-平滑肌肌动蛋白(α-SMA)的表达,比较SBK、准分子激光屈光性角膜切削术(PRK)和准分子激光角膜原位磨镶术(LASIK)手术后早期角膜细胞增生活化情况以及角膜创面的愈合特点,探讨不同手术方式术后组织愈合机制及生物力学差异.方法 新西兰白兔27只,用随机数字表法分为SBK组、LASIK组和PRK组,每组9只,均取右眼为手术眼,左眼为正常对照.于术后7d、1个月、3个月取兔眼角膜,光学显微镜下观察,并行免疫组织化学法检测角膜组织中TGF-β及α-SMA的表达,计数成肌纤维细胞活化数量.结果 SBK组术眼角膜瓣创口边缘上皮细胞增生明显,成肌纤维细胞数量增多,术后7d创口周围TGF-β及α-SMA呈阳性表达,1个月达高峰,3个月减弱.与LASIK组相比,SBK组和PRK组TGF-β的表达差异均有统计学意义(SBK组:t=2.226、2.158、2.330,P＜0.05;PRK组:t=4.745、6.524、6.293,P＜0.05);成纤维细胞数量的差异亦均有统计学意义(SBK组:t=4.439、5.692、4.175,P＜0.05;PRK组:t=6.330、6.723、5.267,P＜0.05).SBK组各时间点TGF-β的表达量均低于PRK组,差异均有统计学意义(t =4.691、5.527、4.399,P＜0.05);α-SMA的表达差异亦均有统计学意义(t=9.637、10.282、8.197,P＜0.05);成纤维细胞数量除3个月时差异无统计学意义外,其余时间点SBK组活化均较PRK组少,差异均有统计学意义( t=5.188、4.529,P＜0.05).结论 与传统LASIK相比,SBK手术的创面活化的成肌纤维细胞、TGF-β和α-SMA表达增多,其愈合反应更强,具有更好的术后生物力学优势,但同PRK相比仍有差距.     

小梁切除术不同结膜瓣滤过泡的形成分析

目的:探讨小梁切除术两种不同结膜瓣术后功能性滤过泡形成情况.方法:比较372例(372只眼)原发性青光眼不同结膜瓣小梁切除术术后功能性滤过泡形成情况,其中以角巩缘为基底的结膜瓣165只眼,以穹窿部为基底的结膜瓣207只眼.结果:术后1周对所有患者进行了观察.3个月时只有127只眼进行了随访.以角巩缘为基底的结膜瓣手术组术后1周滤过泡成功率为83.03%.3个月时为78.69%.以穹窿部为基底的结膜瓣手术组术后1周滤过泡成功率为55.07%,3个月时为53.03%.两组比较有明显差别.结论:本组研究发现.传统的以角巩缘为基底的结膜瓣术后滤过泡成功率高于以穹窿部为基底的结膜瓣,其术后降压效果相应亦较好.     

Trabeculectomy in black Africans in primary open angle glaucoma

PURPOSE: To assess simple trabeculectomy in black Africans with open angle glaucoma. METHODS: We studied retrospectively 80 eyes of 62 patients with primary open angle glaucoma operated by Cairn's trabeculectomy without adjunction of antimetabolites. Thirty seven eyes had a limbal-based conjunctival flap and the others 43 had a fornix-based conjunctival flap. Failures and success were assessed with the Kaplan-Meier's method. RESULTS: Patients were all seen at least 12 months after surgery. The mean follow up was 24 months. At mid-term survey we found complications to be frequent. Pathological blebs occurred in 22.5% (18 cases). The survival probability grew shorter with time. Only 44% of patients were reviewed at 36 months and 29% at 48 months. The success rate (IOP less than 21 mmHg of all glaucoma medications) varied according to the conjunctival flap. It was respectively at 12 months, 24 months and 36 months: 97%, 70 % and 54% with limbal-based flap, and 46%, 18% and 18% with fornix-base flap. The overall rate of tonometric failures was 33.75%. Failures were more often with fornix- based flap (85%). Generally they set in before one year of survey. This was so in 91% of absolute failures and in 87% of relative failures. The failures rate seems to increase with topical polytherapy given more than 12 months before operation. CONCLUSIONS: Trabeculectomy with limbal-based conjunctival flap is at mid-term follow up successful in black Africans. However the following up difficulties in Africa makes it a too delicate assessment objective for long-term results of trabeculectomy.     

筋膜下麻醉小梁切除术

目的：探讨筋膜下麻醉行小梁切除术的有效性及安全性。方法：在连续58例（60眼）青光眼小梁切除术中分别应用表面麻醉、球后麻醉、筋膜下麻醉各20眼,观察麻醉效果、并发症情况。结果：表面麻醉组患者术中在上直肌牵引缝线、巩膜电凝、周边虹膜切除、结膜缝合时有不同程度痛感,筋膜下麻醉、球后麻醉组患者术中无明显痛感,筋膜下麻醉组1眼、球后麻醉组2眼术中出现一过性黑矇,球后麻醉组术中出现球后出血1眼,术后短暂性上睑下垂2眼。结论：小梁切除术采用筋膜下麻醉具有麻醉效果好、并发症少的优点,是理想麻醉方法。     

Bleb reduction and bleb repair after trabeculectomy

OBJECTIVE: To describe methods and outcomes for repair of bleb-related complications of trabeculectomy surgery. DESIGN: Retrospective, consecutive, noncomparative case series. PARTICIPANTS: Thirty-one persons having bleb revision by two surgeons at the Wilmer Institute from 1994 to the present. INTERVENTION: One of two types of revision surgery was performed: bleb reduction to decrease symptoms from large blebs or bleb repair to improve hypotony, using conjunctival rotation flap or free conjunctival autograft. MAIN OUTCOME MEASURES: Visual acuity, intraocular pressure (IOP), reported symptoms, complications, and number of glaucoma medications at the final visit. RESULTS: The mean time from trabeculectomy to bleb revision was 4.4 years. Bleb reduction was performed because of symptomatic, high blebs in 11 eyes of 11 persons. Bleb repair was performed to end bleb leakage in 13 eyes of 13 persons and to increase IOP in 8 eyes of 7 persons with hypotony. Median visual acuity improved from 20/50 before revision to 20/30 at most recent follow-up. Mean IOP increased after treatment from 7.7+/-4.9 to 12.4+/-4.0 mmHg (P < 0.001). Symptoms that caused the revision surgery were eliminated in all cases. None of these eyes has lost IOP control, none has required repeat trabeculectomy, and only 2 of the 32 (6%) require topical glaucoma medication. More than one revision procedure was required in 8 of 32 (25%) eyes. CONCLUSIONS: Surgical bleb revisions for complications after trabeculectomy surgery are safe and effective. Bleb reduction for large, symptomatic blebs or bleb repair for leaking blebs and hypotony did not lead to loss of IOP control.     

Fornix-based versus limbal-based conjunctival flaps in initial trabeculectomy with postoperative 5-fluorouracil: four-year follow-up findings

PURPOSE: To evaluate the safety and efficacy of fornix-based conjunctival flap versus limbal-based flap in initial trabeculectomy with postoperative 5-fluorouracil. METHODS: 29 patients (58 eyes) with bilateral primary open-angle glaucoma (POAG) were included in the study. Patients were randomly assigned to have a fornix-based conjunctival flap in one eye and a limbal-based flap in the other, followed by subconjunctival injection of 5-fluorouracil. RESULTS: Mean intraocular pressure (IOP) 2 years after treatment was 12.9 +/- 12.25 mmHg in eyes with fornix-based conjunctival flaps and 13.1 +/- 16.81 mmHg in eyes with limbal-based conjunctival flaps. At 4 years, mean IOP was 14.7 +/- 9.61 mmHg in eyes with fornix-based conjunctival flaps and 15.1 +/- 7.29 mmHg in eyes with limbal-based conjunctival flaps. Cumulative success at 4 years (IOP < 21 mmHg) was 89.6% in eyes with fornix-based conjunctival flaps versus 86.2% in eyes with limbal-based conjunctival flaps with medications. Cystic leaking blebs occurred in two cases, both with limbal-based flaps. CONCLUSION: The efficacy of limbal- and fornix-based conjunctival flaps in initial trabeculectomy with postoperative 5-fluorouracil was not significantly different; however, in this study cystic leaking blebs were encountered only in eyes with limbal-based conjunctival flaps.     

小梁切除术后浅前房原因分析

目的:探讨小梁切除术手术后浅前房发发生原因及处理原则。方法:分析小梁切除术手术患者182例308眼发生浅前房的比率及处理方法。结果:小梁切除术术后浅前房38例42眼(13.6%),其中引流过畅21眼、脉络膜脱离17眼,结膜瓣渗漏2眼,恶性青光眼2眼,33眼行保守治疗(78.6%),7眼行前房重建术,1眼行结膜瓣修复,1眼行晶状体摘除术及玻璃体抽吸术。结论:小梁切除术术后浅前房发生率较高,其最常见原因为脉络膜脱离及房水引流过畅,大多数浅前房通过非手术治疗,在前房重建中效果良好。     

Mitomycin C trabeculectomy in eyes with cicatricial conjunctiva

PURPOSE: To demonstrate favorable outcome of mitomycin C–augmented trabeculectomy in eyes with broad cicatricial conjunctiva created by previous surgeries.METHODS: Forty-six eyes (40 patients) with extensive conjunctival scarring that had undergone mitomycin C trabeculectomy were reviewed retrospectively.RESULTS: After a mean follow-up ± SD of 13.7 ± 7.8 months (range, 6 to 36 months), intraocular pressure was well controlled, below or equal to 16 mm Hg and 21 mm Hg, respectively, in 33 (72%) and 44 (96%) of the 46 eyes. In all eyes, a functional filtering bleb was present during the follow-up periods.CONCLUSION: Mitomycin C trabeculectomy after dissection of conjunctival scar tissue may be useful for treating refractory glaucoma.     

两种瓣式小梁切除术后辅助眼球按摩对形成功能性滤过泡的影响

目的:比较穹隆部为基底的球结膜瓣和角膜缘为基底的球结膜瓣在青光眼复合式小梁切除术后辅助眼球按摩治疗对形成功能性滤过泡的影响。方法:将51例61眼原发青光眼并接受复合小梁切除术患者随机分成两组:A组26例31眼以角膜缘为基底的球结膜瓣;B组25例30眼以穹隆部为基底的球结膜瓣。术后观察两组患者眼压、滤泡、前房深度,并根据情况适时辅助眼球按摩治疗。全部患者术后观察6mo。结果:两种结膜瓣的复合式小梁切除术均有显著降眼压效果(P<0.01);功能性滤过泡的形成率也无统计学差异(P>0.05);术后早期眼球按摩促进滤泡形成中出现被动性滤泡渗漏B组多于A组。结论:两种结膜瓣的复合小梁切除术治疗青光眼都有相同良好的效果。眼球按摩可促进形成功能性滤过泡。角膜缘为基底球结膜瓣的复合小梁切除术后眼球按摩治疗不易出现被动性滤泡渗漏。     

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.     

血小板源性生长因子受体a在兔增殖性玻璃体视网膜病变中的作用

目的 血小板源性生长因子(platelet-derived growth factor,PDGF)可引起增殖性玻璃体视网膜病变,本研究评价特异性的PDGF-a受体酪氨酸激酶阻断剂AG1295对兔PVR的治疗作用.方法 兔结膜成纤维细胞(rabbit conjunctical fibroblats,RCF)培养,用MTT法检测PDGF-AA和-BB以及AG1295和AG1296对兔RCF增殖状况的影响.眼视网膜电图检查和HE染色分析药物的毒性.建立PVR动物模型,玻璃体腔内分别给予AG1295和AG1296.用牵引性视网膜脱离(tractional ratinal detachment,TRD) 的发生率评价药物的体内疗效.结果 体外10umol/L的AG1295和AG1296和均可显著抑制由PDGF-AA和-BB诱导的成纤维细胞的增生,体内100umol/L AG1295和AG1296均减慢了兔TRD的发生,但AG1295的作用仅持续至14d.相同浓度的AG1296和AG1295相比,作用更持久.在两个治疗组中,均未发现明显的视网膜毒性.结论 特异性的PDGF-a受体酪氨酸激酶抑制剂AG1296可显著抑制兔TRD的发生,其作用明显强于PDGF-a受体酪氨激酶抑制AG1295,提示PDGF对PBR的促进作用主要由a受体介导,这一通路的阻断可能成为治疗PVR的一种方法.