吡非尼酮浸泡生物羊膜对兔青光眼模型滤过术后瘢痕形成的作用

目的:探讨吡非尼酮(PFD)浸泡生物羊膜在兔青光眼模型中的应用，评价其对兔青光眼模型的抗瘢痕效果及毒副作用。方法:健康新西兰白兔72只右眼采用前房注射复方卡波姆溶液的方法建立青光眼模型后随机分为0.5%PFD+生物羊膜组、单纯生物羊膜组、丝裂霉素C(MMC)组和空白对照组，每组18只，均行小梁切除术，其中0.5%PFD+生物羊膜组在巩膜瓣下放置0.5%PFD溶液浸泡的生物羊膜，单纯生物羊膜组在巩膜瓣下放置生理盐水浸泡的复水生物羊膜，MMC组在巩膜瓣下放置浸有MMC的棉片3 min后立即采用生理盐水冲洗，空白对照组制作巩膜瓣后不放入任何植入物。评估眼压、滤过泡及毒副作用和并发症情况，并采用苏木精-伊红(HE)、Masson染色及免疫组织化学染色法观察滤过区组织病理变化。结果:小梁切除术后14、21、28 d各组眼压比较，0.5%PFD+生物羊膜组

Effect of biological amniotic membrane soaked in pirfenidone on scar formation after glaucoma filtration surgery in rabbit eyes

AIM: To investigate the application of biological amniotic membrane soaked in pirfenidone(PFD)and to evaluate its anti-scarring effect and toxic side effects on glaucoma model of rabbit eyes.

METHODS: The right eyes of 72 healthy New Zealand white rabbits were randomly divided into 0.5%PFD+ biological amniotic membrane group, biological amniotic membrane group, mitomycin C(MMC)group and blank control group after the glaucoma model was established by anterior chamber injection of compound carbomer solution, and 18 rabbits in each group underwent trabeculectomy, in which the 0.5% PFD+ biological amniotic membrane group was placed with 0.5% PFD solution-soaked biological amniotic membrane under the scleral flap, and the biological amniotic membrane group was placed with normal saline-soaked rehydrated biological amniotic membrane under the scleral flap. In the MMC group, a cotton pad soaked in MMC was placed under the scleral flap for 3 min and immediately rinsed with normal saline, while the blank control group received no implant after the scleral flap was made. The intraocular pressure(IOP), filtration blebs, toxic side effects and complications were evaluated, and the histopathological changes in the filtration area were observed by hematoxylin-eosin(HE), Masson staining and immunohistochemical staining.

RESULTS: The mean IOP at 14, 21 and 28 d after trabeculectomy were 0.5%PFD+ biological amniotic membrane groupP<0.05). At 28 d after trabeculectomy, 0.5%PFD+ biological amniotic membrane group had the best effect of anti-inflammatory hyperplasia and inhibition of collagen formation, the highest survival rate of filtration blebs, and the inflammatory reaction was mild.

CONCLUSION: Biological amniotic membrane soaked in pirfenidone has more obvious anti-scarring effect on glaucoma model, with less toxic side effects and good safety.