消炎痛防治电光性眼炎的研究

采用放免方法测定正常家兔角膜上皮内ＰＧＥ１、ＰＧＥ２、ＰＧＦ２α、ＰＧＩ２、ＴＸＡ２等前列腺素含量。并在紫外线照射前后分别采用０．２５％消炎痛油型滴剂滴眼。６小时后再次测定兔角膜上皮内ＰＧ５，发现ＰＧＥ、ＰＧＥ２、ＰＧＩ２和ＴＸＡ２合成均受到明显抑制（Ｐ＜０．０５－０．０１），且角膜炎症症反应较轻。但照射前后用药对角膜上皮内ＰＧ５合成的抑制无显著性差异（Ｐ＞０．０５）。结果提示前列腺素在电光性眼炎     

过氧亚硝酸根联合碱性成纤维细胞生长因子对人晶状体上皮细胞细胞外信号调节激酶（ERK）磷酸化水平的影响

目的　探讨过氧亚硝酸根（ｐｅｒｏｘｙｎｉｔｒｉｔｅ,ＯＮＯＯ－）和重组人碱性成纤维细胞生长因子（ｒｅｃｏｍｂｉｎａｎｔｈｕｍａｎｂａｓｉｃｆｉｂｒｏｂｌａｓｔｇｒｏｗｔｈｆａｃｔｏｒ,ｂＦＧＦ）共同作用对人晶状体上皮细胞细胞外信号调节激酶（ＥＲＫ）磷酸化水平的影响。初步探讨ＯＮＯＯ－导致白内障发生的可能机制。方法　将培养的ＨＬＥＣ细胞分为４组,对照组（未经ＯＮＯＯ－和ｂＦＧＦ处理）、ｂＦＧＦ单独处理组、ｂＦＧＦ＋ＯＮＯＯ－处理组［ｂＦＧＦ预处理１ｈ后加入不同浓度ＯＮＯＯ－（５０μｍｏｌ·Ｌ－１、１００μｍｏｌ·Ｌ－１、２００μｍｏｌ·Ｌ－１）处理１ｈ］和ＯＮＯＯ－ ＋ｂＦＧＦ处理组［不同浓度ＯＮＯＯ－（５０μｍｏｌ·Ｌ－１、１００μｍｏｌ·Ｌ－１、２００μｍｏｌ·Ｌ－１）预处理１ｈ后加入ｂＦＧＦ处理１ｈ］。检测各组细胞内ＥＲＫ磷酸化水平的变化。结果　ｂＦＧＦ单独处理组和ｂＦＧＦ ＋ＯＮＯＯ－（５０μｍｏｌ·Ｌ－１、１００μｍｏｌ·Ｌ－１、２００μｍｏｌ·Ｌ－１）处理组中磷酸化ＥＲＫ相对表达值分别为５．１７±０．３５、４．４２±０．１２、３．９１±０．１５和０．４９±０．０８,与对照组（１．００±０．０５）相比差异有统计学意义（Ｆ＝４０２．８３,Ｐ＜０．００１）,结果显示ＯＮＯＯ－可以抑制由ｂＦＧＦ诱导的ＥＲＫ磷酸化水平的增加（Ｆ＝３１０．３４,Ｐ＜０．０５）。ＯＮＯＯ－（５０μｍｏｌ·Ｌ－１、１００μｍｏｌ·Ｌ－１、２００μｍｏｌ·Ｌ－１）＋ｂＦＧＦ处理组中磷酸化ＥＲＫ相对表达值分别为３．３６±０．０４、３．３２±０．０６和２．９２±０．０８,与对照组（１．００±０．０２）相比,所有处理组的ＥＲＫ磷酸化水平均显著增加（Ｆ＝５１８．９４,Ｐ＜０．００１）;５０μｍｏｌ·Ｌ－１和１００μｍｏｌ·Ｌ－１ＯＮＯＯ－处理细胞后经ｂＦＧＦ处理,ＥＲＫ磷酸化水平较ｂＦＧＦ单独处理组（３．０４±０．０５）显著增加（Ｆ＝３５．５３,Ｐ＜０．０５）,而２００μｍｏｌ·Ｌ－１ＯＮＯＯ－处理组与ｂＦＧＦ单独处理组相比差异无统计学意义（Ｐ＞０．０５）。结论　ＯＮＯＯ－诱导的白内障的发生可能与ＥＲＫ磷酸化的紊乱有关。     

生长因子对培养人眼视网膜色素上皮细胞增殖的调控作用

目的探讨生长因子对人眼视网膜色素上皮（ｒｅｔｉｎａｌｐｉｇｍｅｎｔｅｐｉｔｈｅｌｉｕｍ，ＲＰＥ）细胞增殖的调控作用。方法建立人眼ＲＰＥ细胞培养体系，利用３Ｈ－ＴｄＲ掺入法和细胞计数观察表皮生长因子（ｅｐｉｄｅｒｍａｌｇｒｏｗｔｈｆａｃｔｏｒ，ＥＧＦ）、碱性成纤维细胞生长因子（ｂａｓｉｃ－ｆｉｂｒｏｂｌａｓｔｇｒｏｗｔｈｆａｃｔｏｒ，ｂ－ＦＧＦ）、胰岛素样生长因子（ｉｎｓｕｌｉｎ－ｌｉｋｅｇｒｏｗｔｈｆａｃｔｏｒ，ＩＧＦ－Ｉ）对培养ＲＰＥ细胞的作用。结果（１）ＥＧＦ，ｂ－ＦＧＦ，ＩＧＦ－Ⅰ与对照组比较，可明显增强人眼ＲＰＥ细胞ＤＮＡ合成６．６～１２．２倍，增强能力为ＥＧＦ＞ｂ－ＦＧＦ＞ＩＧＦ－Ⅰ。（２）当生长因子联合作用时，可数倍明显增强３Ｈ－ＴｄＲ掺入，能较单一因子更有效地刺激人眼ＲＰＥ增殖。结论结果提示，生长因子的协同作用可能是增殖性视网膜病变发生的重要机理之一。     

转化生长因子-β2（TGF-β2）诱导人视网膜色素上皮层细胞上皮-间质转分化中miRNA-29b的表达及意义

目的　探究转化生长因子-β２（ｔｒａｎｓｆｏｒｍｉｎｇｇｒｏｗｔｈｆａｃｔｏｒ-β２,ＴＧＦ-β２）诱导人视网膜色素上皮（ｒｅｔｉｎａｌｐｉｇｍｅｎｔｅｐｉｔｈｅｌｉａｌ,ＲＰＥ）层细胞上皮-间质转分化中ｍｉＲＮＡ-２９ｂ的表达变化及意义。方法　使用不同浓度ＴＧＦ-β２刺激ＲＰＥ细胞上皮-间质转分化后,倒置相差显微镜观察细胞形态变化,Ｗｅｓｔｅｒｎｂｌｏｔ、ＲＴ-ＰＣＲ检测成纤维化相关分子纤维连接蛋白（ｆｉｂｒｏｎｅｃｔｉｏｎ,ＦＮ）、神经钙粘连蛋白（ｎｅｒｖｅｃａｌｃｉｕｍａｄｈｅｓｉｏｎｐｒｏ-ｔｅｉｎ,Ｎ-Ｃａｄｈｅｒｉｎ）的表达。采用ＲＴ-ＰＣＲ检测不同浓度ＴＧＦ-β２及不同时间ＴＧＦ-β２（５μｇ·Ｌ－１）刺激ＲＰＥ细胞后ｍｉＲＮＡ-２９ｂ的表达。结果　ＴＧＦ-β２刺激后的ＲＰＥ细胞形态呈纤维化改变。在一定浓度范围内（１μｇ·Ｌ－１、５μｇ·Ｌ－１、１０μｇ·Ｌ－１）,随着ＴＧＦ-β２浓度的增加ＦＮ、Ｎ-Ｃａｄｈｅｒｉｎ及相应ｍＲＮＡ随之增加,１μｇ·Ｌ－１、５μｇ·Ｌ－１、１０μｇ·Ｌ－１组与对照组（０μｇ·Ｌ－１）相比,差异均有统计学意义（均为Ｐ＜０．０１）。ＴＧＦ-β２在一定浓度范围内（０μｇ·Ｌ－１、１μｇ·Ｌ－１、５μｇ·Ｌ－１）以剂量依赖的方式诱导ＲＰＥ细胞ｍｉＲＮＡ-２９ｂ表达的降低,１μｇ·Ｌ－１、５μｇ·Ｌ－１、１０μｇ·Ｌ－１组与对照组（０μｇ·Ｌ－１）相比,差异均有统计学意义（均为Ｐ＜０．０１）,在ＴＧＦ-β２浓度为５μｇ·Ｌ－１时ｍｉＲＮＡ-２９ｂ表达量最低。ＴＧＦ-β２在一定时间范围内（０ｈ、３ｈ、６ｈ、１２ｈ）以时间依赖的方式诱导ＲＰＥ细胞ｍｉＲＮＡ-２９ｂ表达的降低,３ｈ、６ｈ、１２ｈ、２４ｈ、４８ｈ组与０ｈ相比差异均有统计学意义（均为Ｐ＜０．０５）。结论　一定范围内ＴＧＦ-β２以剂量和时间依赖的方式诱导ＲＰＥ细胞ｍｉＲＮＡ-２９ｂ的表达,为进一步研究ｍｉＲＮＡ-２９ｂ与ＴＧＦ-β２在ＲＰＥ细胞上皮-间质转分化过程中的相互作用提供理论基础。     

干扰素α-2b与丝裂霉素C用于青光眼滤过术的临床对比研究

目的 评价干扰素α－２ｂ（ｉｎｔｅｒｆｅｒｏｎ α－２ｂ,ＩＦＮ α－２ｂ）与丝裂霉素Ｃ（ｍｉｔｏｍｙｃｉｎ Ｃ,ＭＭＣ）用于青光眼滤过术的临床疗效及应用价值。方法 采取随机对照临床试验研究方法,将４１例（６８只眼）晚期原发性开角型青光眼（ｐｒｉｍａｒｙ ｏｐｅｎ ａｎｇｌｅ ｇｌａｕｃｏｍａ,ＰＯＡＧ）患者分为两组。每组各有３４只眼,其中２７例为同一患者左右眼对照;患者年龄１５～４０岁,均为衩手     

干扰素对眶成纤维细胞GAG生成的刺激作用

目的观察干扰素（ｉｎｔｅｒｆｅｒｏｎ，ＩＦＮ）对眼眶成纤维细胞（ｆｉｂｒｏｂｌａｓｔ，Ｆｂ）生成糖胺聚糖（ｇｌｙｃｏｓａｍｉｎｏｇｌｙｃａｎｓＧＡＧ）的作用。方法取５例甲状腺相关眼病（ｔｈｙｒｏｉｄａｓｓｏｃｉａｔｅｄｏｐｈｔｈａｌｍｏｐａｔｈｙ，ＴＡＯ）患者的眶组织标本进行眶成纤维细胞的培养，另取５例非甲状腺相关眼病患者的标本做对照。在培养的成纤维细胞中加入不同浓度的干扰素－α和干扰素－γ。使用３Ｈ标记物和液体闪烁分析器检测干扰素对眶成纤维细胞产生ＧＡＧ的作用。结果干扰素－γ可明显地刺激成纤维细胞生成ＧＡＧ且对甲状腺相关眼病患者的作用强于对正常人的作用，干扰素－α无此作用。结论干扰素－γ是眶成纤维细胞产生ＧＡＧ较强的刺激因子。     

Bevacizumab对人Tenon囊成纤维细胞转分化的抑制作用

目的　观察Ｂｅｖａｃｉｚｕｍａｂ（贝伐单抗）对转化生长因子（ｔｒａｎｓｆｏｒｍｉｎｇｇｒｏｗｔｈｆａｃｔｏｒ,ＴＧＦ）-β２诱导下的人Ｔｅｎｏｎ囊成纤维细胞转分化的抑制作用,探讨抗新生血管药物抑制青光眼术后滤过泡瘢痕化的机制。方法　用含体积分数１０％胎牛血清的ＤＭＥＭ高糖型培养基对人Ｔｅｎｏｎ囊成纤维细胞株进行体外常规培养和传代。实验分为空白对照组、ＴＧＦ-β２处理组（加入终浓度为１０μｇ?Ｌ－１的ＴＧＦ-β２ＤＭＥＭ完全培养基）及Ｂｅｖａｃｉｚｕｍａｂ干预组（加入１０μｇ?Ｌ－１的ＴＧＦ-β２和１．０ｇ?Ｌ－１的ＢｅｖａｃｉｚｕｍａｂＤＭＥＭ完全培养基）,置于３７℃、体积分数５％二氧化碳培养箱中培养４８ｈ,并分别应用细胞免疫荧光染色技术和ＷｅｓｔｅｒｎＢｌｏｔ实验检测Ｂｅｖ-ａｃｉｚｕｍａｂ对ＴＧＦ-β２刺激下人Ｔｅｎｏｎ囊成纤维细胞α-平滑肌肌动蛋白（α-ｓｍｏｏｔｈｍｕｓｃｌｅａｃｔｉｎ,α-ＳＭＡ）表达的影响。结果　α-ＳＭＡ蛋白主要表达在细胞质中,免疫荧光染色结果显示ＴＧＦ-β２处理组可以见到α-ＳＭＡ的荧光表达,而Ｂｅｖａｃｉｚｕｍａｂ干预组α-ＳＭＡ蛋白表达受到抑制。ＷｅｓｔｅｒｎＢｌｏｔ结果显示空白对照组、ＴＧＦ-β２ 处理组及Ｂｅｖａｃｉｚｕｍａｂ干预组α-ＳＭＡ蛋白相对表达量分别为０．６３０±０．０３８、１．１３０±０．０７１和０．３４０±０．０３３,Ｂｅｖａｃｉｚｕｍａｂ干预组α-ＳＭＡ蛋白相对表达量低于空白对照组和ＴＧＦ-β２处理组（均为Ｐ＜０．０５）。结论　Ｂｅｖａｃｉｚｕｍａｂ可明显抑制ＴＧＦ-β２诱导下人Ｔｅｎｏｎ囊成纤维细胞α-ＳＭＡ蛋白的表达,抑制成纤维细胞表型转化。     

早期原发性开角型青光眼彩色图形视网膜电图的特征

目的观察早期原发性开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎａｎｇｌｅｇｌａｕｃｏｍａ，ＰＯＡＧ）彩色图形视网膜电图（ｃｏｌｏｒｐａｔｔｅｒｎｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ，ＣＰ－ＥＲＧ）的改变特征。方法对２９例（４８只眼）ＰＯＡＧ，１０例（１６只眼）高眼压症及３３例（４８只眼）年龄匹配的正常人做ＣＰ－ＥＲＧ检测，并进行统计学比较及多因素分析。结果早期ＰＯＡＧ的ＣＰ－ＥＲＧ的Ｐ１、Ｎ２波幅下降，红黑Ｎ２与蓝黑Ｐ１峰时间延长；部分高眼压症已出现Ｎ２波幅下降。采用多因素逐步判别分析方法，筛选出对早期ＰＯＡＧ诊断有判别能力的５项指标：蓝黑Ｎ２波幅、红黑Ｐ１波幅、红黑Ｎ２波幅、红黑Ｎ２峰时间及白黑Ｐ１波幅与Ｎ２波幅的比值，同时建立了判别函数。结论ＣＰ－ＥＲＧ是检测早期ＰＯＡＧ视网膜功能改变的有效方法，有助于早期ＰＯＡＧ的诊断。     

碱性成纤维细胞生长因子和胰岛素样生长因子-I及其协同作用对牛晶体上皮细胞增殖的影响

目的　研究碱性成纤维细胞生长因子（ｂａｓｉｃｆｉｂｒｏｂｌａｓｔｇｒｏｗｔｈｆａｃｔｏｒ，ｂＦＧＦ）、胰岛素样生长因子Ｉ（ｉｎｓｕｌｉｎｌｉｋｅ ｇｒｏｗｔｈ ｆａｃｔｏｒＩ，ＩＧＦⅠ） 及二者的共同作用对体外牛晶体上皮细胞（ｂｏｖｉｎｅ ｌｅｎｓｅｐｉｔｈｅｌｉａｌｃｅｌｌ，ＢＬＥＣ）增殖的影响。方法　ＢＬＥＣ原代培养，取第４ 代细胞种入２４ 孔板，加入不同浓度的ｂＦＧＦ、ＩＧＦⅠ、ｂＦＧＦ＋ ２０ μｇ／ＬＩＧＦⅠ，２０ ｈ 后加入３ＨＴＤＲ，１６ ｈ 后作液闪计数。结果　一定浓度的ｂＦＧＦ（１～１００ μｇ／Ｌ） 、ＩＧＦⅠ（２０～１００ μｇ／Ｌ） 在体外有促进ＢＬＥＣ 增殖的作用（ Ｐ＜ ０－０１ ） ，２０ μｇ／Ｌ的ＩＧＦⅠ可增加ｂＦＧＦ的促ＢＬＥＣ增殖作用。结论　生长因子及它们之间的协同作用在促进晶体上皮细胞异常增殖的过程中起重要作用。     

碱性成纤维细胞生长因子和胰岛素样生长因子—Ⅰ及其协同作用对？…

目的 研究碱性成纤维细胞生长因子（ｂａｓｉｃ ｆｉｂｒｏｂｌａｓｔ ｇｒｏｗｔｈ ｆａｃｔｏｒ,ｂＦＧＦ）、胰岛素样生长因子－１（ｉｎｓｕｌｉｎ－ｌｉｋｅ ｇｒｏｗｔｈ ｆａｃｔｏｒ－１,ＩＧＦ－１）及二者的共同作用对体外牛晶体上皮细胞（ｂｏｖｉｎｅ ｌｅｎｓｅｐｉｔｈｅｌｉａｌ ｃｅｌｌ,ＢＬＥＣ）增殖的影响。方法 ＢＬＥＣ原代培养,取第４例细胞种入２４孔板,加入不同浓度的ｂＦＧＦ、ＩＧＦ－１,     

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.     

角膜缘小切口小梁切除术的设计及临床观察

目的　探讨角膜缘小切口小梁切除术的方法并观察其治疗各型原发性青光眼的效果。方法　结膜止点切开 ,切口长 4.0mm ;角膜缘前界板层切开 ,切口长 3 .5mm ;角巩膜瓣下阶梯状小梁切除联合浅层巩膜切开及深层巩膜表面中部纵向电凝。对术后视力、眼压、滤过泡及手术并发症进行总结。结果　术后随访 6～ 42月 ,所有病例角膜上皮无损伤 ,角膜缘切口无渗漏 ,3 4例 ( 46眼 )中 43眼滤过泡扁平弥散 ,3眼滤过泡不明显 ,眼压平均为 ( 16.78± 4.3 8)mmHg( 1mmHg =0 13 3kPa)。结论　该手术方法操作简便、组织损伤小 ,降低了滤过道瘢痕形成的发生率     

Inhibitory effects of trehalose on fibroblast proliferation and implications for ocular surgery

Trehalose is a disaccharide which plays an important role in preserving cells from completely dehydrated circumstances. In this study, we investigated effects of trehalose on proliferative activity of fibroblasts and epithelial cells both in vitro and in vivo. As in vitro assessment, normal human dermal fibroblasts and normal human epidermal keratinocytes were cultured in media containing various concentrations of trehalose. Growth activities of cells were evaluated with MTT assay and diff-quick™ staining. Expressions of vimentin and α smooth muscle actin (α-SMA) changed by trehalose were semiquantitatively measured by Western blot. As an in vivo study, 5% or 10% trehalose was topically instilled onto rabbit eyes after simple conjunctival incision or trabeculectomy. Condition of the surgical wound was evaluated by morphologically and immunohistochemically using isolectin B4 and antibodies specific for vimentin and α-SMA. Intraocular pressures (IOPs) after trabeculectomy were compared between eyes treated with trehalose and 0.04% mitomycin C (MMC). Results obtained by in vitro experiments showed that growth activities of cultured fibroblasts and keratinocytes were inhibited by trehalose in a dose-dependent manner. Fibroblasts were strongly inhibited by trehalose concentrations ≧ 5% of trehalose, whereas keratinocytes were less inhibited compared to fibroblasts. Expressions of vimentin and α-SMA were reduced by trehalose. With in vivo experiments, postoperative application of trehalose resulted in less firm adhesion between conjunctiva and sclera compared to controls. Immunohistochemical studies showed reduced staining of isolectin B4, vimentin and α-SMA in conjunctival wounds treated by topical trehalose. Also, after trabeculectomy, IOP remained in a low range during instillation of topical trehalose solution. We concluded that trehalose has inhibitory effects on proliferation of fibroblasts and vascular tissues, partially due to inhibition of transformation of fibroblasts into myofibroblasts in wound tissues. The present results imply that trehalose can be a potential agent for preventing postoperative fibrous scar formation after ocular surgery such as glaucoma filtration surgery.     

Racial differences in the results of glaucoma filtration surgery: are racial differences in the conjunctival cell profile important?

Conjunctival biopsies were obtained at the time of filtration surgery from 90 patients with glaucoma; 45 of these patients were black and 45 white. Forty nine of the patients (25 black, 24 white) had undergone a primary trabeculectomy. Comparisons between black and white patients were made with respect to the results of surgery and differences in conjunctival cell profile. In agreement with many authors, trabeculectomy was found to be less successful in black patients (67% compared with 80%), although this finding was not statistically significant by survival analysis. In addition, conjunctiva from black patients was found to contain a greater number of macrophages and a smaller number of both mast cells and goblet cells in comparison with white patients. There was a tendency for conjunctiva from black patients to contain more fibroblasts. Conjunctiva obtained from the patients whose filtration surgery subsequently failed was found to contain more fibroblasts, macrophages, and basal epithelial pale cells. A greater number of conjunctival macrophages and possibly fibroblasts in black patients may partially explain the tendency for a lower success rate of filtration surgery in this group of patients.     

Comparison of deep sclerectomy with collagen implant and trabeculectomy in open-angle glaucoma

PURPOSE: To assess the efficacy and postoperative complications of deep sclerectomy with collagen implant (DSCI), a nonpenetrating filtration procedure. SETTING: Glaucoma Unit, Department of Ophthalmology, University of Lausanne, Switzerland. METHODS: Forty-four eyes of 44 patients with medically uncontrolled open-angle glaucoma had DSCI and a matched control group of 44 patients, trabeculectomy. A superficial scleral flap was raised and a deep sclerectomy performed in the scleral bed. Schlemm's canal was opened, and the cornea was dissected to Descemet's membrane. At that stage, aqueous filtered through the remaining trabeculo-Descemet's membrane. A collagen implant was sutured radially in the scleral bed; the scleral flap and conjunctiva were then closed. Examinations were performed before surgery and postoperatively at 1 and 7 days and 1, 2, 3, 6, 9, 12, 15, 18, and 24 months. RESULTS: The mean follow-up was 14.4 months +/- 6.3 (SD) (range 3 to 24 months). The mean preoperative intraoperative pressure (IOP) was 26.7 +/- 7.3 mm Hg. The mean postoperative IOP was 6.1 +/- 4.5 mm Hg at 1 day and 11.0 +/- 4.4 mm Hg at 1 week; it remained stable for the next 24 months. The success rate, defined as an IOP lower than 21.0 mm Hg without medication, was 69% in the DSCI group and 57% in the trabeculectomy group at 24 months postoperatively (P = .047). The number of postoperative complications was significantly lower in the DSCI group than in the trabeculectomy group. CONCLUSIONS: The success rate of DSCI may be comparable to that of trabeculectomy, with fewer complications.     

无结膜切口小梁切除术临床疗效观察

目的减少抗青光眼术后滤过泡的瘢痕形成，提高手术成功率。方法对３５例（３７只眼）青光眼施行无结膜切口小梁切除术。结果经３～１６个月随访，眼压控制率达９４．６％，并发症少而轻。结论无结膜切口小梁切除术是一种安全、有效的抗青光眼手术。     

Enhanced short-term plasmid transfection of filtration surgery tissues

PURPOSE: To quantify and localize plasmid transfection of filtration surgery tissues using two delivery techniques. METHODS: Full-thickness filtering procedures were performed on eyes of New Zealand albino rabbits. In 10 eyes, naked plasmid DNA in saline was either injected beneath Tenon's capsule at the filtration site or absorbed into a collagen shield that was then placed external to the sclerostomy and under the Tenon's capsule. Forty-eight hours after surgery, levels of the reporter gene, chloramphenicol acetyltransferase (CAT) were measured in samples of ocular tissues. In two additional eyes, the ss-galactosidase (ss-GAL:) reporter gene expression was localized histologically. RESULTS: Injection of plasmid DNA in saline vehicle into the filtration bleb produced readily detectable CAT activity in bleb tissue (conjunctiva, Tenon's capsule, and sclera) whereas CAT activity was nearly undetectable in samples of the cornea, iris-ciliary body, and tissues located opposite the bleb site. Delivery of the plasmid DNA into the bleb through a collagen shield increased CAT activity 30-fold over injection of plasmid in saline (2711 +/- 567 mU/mg versus 92 +/- 38 mU/mg). ss-Gal activity was imaged only in the region of the bleb, and microscopic examination showed ss-Gal activity localized to Tenon's capsule fibroblasts, with minimal ss-Gal activity observed in inflammatory cells or scleral fibroblasts. CONCLUSIONS: Transfection of filtration tissues is enhanced by absorption of naked DNA into a collagen shield. Furthermore, transfection is localized to the fibroblasts and inflammatory cells of the filtration bleb site. Gene therapy using naked plasmid DNA and a simple collagen shield delivery vehicle may be useful for regulating wound healing after glaucoma surgery.     

He-Ne激光对兔眼小梁切除术后滤过道瘢痕化的影响及其机制

目的:研究He-Ne激光对兔眼小梁切除术后滤过道瘢痕化的影响及其机制,探讨He-Ne激光在青光眼小梁切除术中的应用价值。方法:于小梁切除手术前采用功率密度200mW/cm2He-Ne激光照射兔眼(右眼)手术区,照射部位选择鼻上象限角膜缘紧邻上直肌处,光斑直径4mm,照射时间10min,1次/d,连续照射3d。最后一次照射后24h实施双眼小梁切除术。手术后第7,14,28d检测手术区组织结缔组织生长因子(connective tissue growth factor,CTGF);第14和第28d检测胶原密度(masson染色)。左眼设为单纯手术对照组。每时间点各7只兔。结果:手术后第7,14d,He-Ne激光组CTGF表达较对照组减少(P=0.01;P=0.005)。手术后第14,28dHe-Ne激光组胶原密度显著低于对照组(P=0.013;P=0.01)。结论:功率密度200mW/cm2He-Ne激光预照射小梁切除术手术区域,可下调术后该区域成纤维细胞CTGF表达并减少胶原合成,可能有助于减少兔眼小梁切除术后滤过道瘢痕形成。He-Ne激光有可能为预防青光眼滤过手术后瘢痕化提供新的方法。     

Influence and mechanism of He-Ne laser on scar formation of filtration canal after trabeculectomy in rabbit

AIM: To investigate the influence of He-Ne laser on connective tissue growth factor (CTGF) expression and collagen formation of fibroblast in filtration site after trabeculectomy in rabbit, and to discuss the mechanism for preventing scar formation with He-Ne laser in vivo. METHODS: The upper nasal limbus area next to the upper rectus muscle in right eyes received 10 minutes He-Ne laser irradiation (200mW/cm2) every day for three days, the left eyes served as control. Twenty-four hours after the last irradiation, both eyes of the rabbits were took trabeculectomy surgery. The expressions of CTGF in the filtration area were tested on the 7th, 14th and 28th day after surgery and collagen density was tested on the 14th and 28th day after surgery. Each of the time point had 7 rabbits. RESULTS: The expression of CTGF was lower than that of the control group's on the 7th and 14th day after trabeculectomy surgery (P=0.01, P=0.005). When examined on the 14th and 28th day, the collagen density of irradiation group were significantly lower than that of the control group's (P=0.013, P=0.01). CONCLUSION: Pretreating the filtration area with 200mW/cm2 He-Ne laser may be helpful in preventing scar formation after trabeculectomy in rabbit, possibly due to downregulation of the expression of CTGF and collagen synthesis in fibroblasts. He-Ne laser may be developed into a new scar preventing method in filtration surgery.