眼内窥镜下睫状体光凝的组织病理学研究

目的 探讨眼内窥镜下睫状体光凝后兔眼睫状体细胞的变化发展过程，为临床研究提供参考资料。方法取20只青紫蓝兔进行眼内窥镜下睫状体光凝，在光凝后即刻、3d、1周、1个月和3个月光镜和透射电镜观察睫状突的结构变化过程。结果光凝后即刻睫状突组织破坏，基质血管扩张。以后组织破坏加重并出现上皮囊肿。随时问推移，睫状体组织结构紊乱，有形成分减少。结论眼内窥镜下睫状体光凝可有效地破坏睫状突结构，并使这种破坏呈不可逆。安全性好，对周围组织无破坏，是一种较为理想的青光眼治疗方法。

Histopathologic study of endoscopic photocoagulation

ObjectiveTo investigate the morphological changes of ciliary processes after endoscopic cyclophotocoagulation (ECT) in rabbit eyes.MethodsTwenty pigmented rabbits received endoscopic cyclophotocoagulation with diode laser.Microscopic structure and ultrastructure of ciliary processes were observed less than 30 minute and at 3,7,28,90 day after cyclophotocoagulation under the light and electron microscope.ResultsAfter the endolaser photocoagulation was performed,the damage of ciliary processes included ciliary epithelia thinning and vascular congestion of the stroma immediately.The numbers of cysts were increased in the pigmented and nonpigmented ciliary epithelia with the survival time.The nonpigmented epithelium was collapsed or thinned,and the pigment clumped and stromal edema was alleviated.By month 3 after laser treatment,the degree of damage was more pronounced.The ciliary processes were shortened and exhibited fusion in the ciliary body.Transmission electron microscopic study showed edema and vacuolae of mitochondria crests in the nonpigmented epithelium immediately after cyclophotocoagulation and appeared dissolution chromatin of capillary endothelial cells nucleus 3 days later.Three months after cyclophotocoagulation,mitochondria dissolved,and the cell composition was thrown into confusion.No regeneration of the ciliary processes was found.ConclusionECT can induce irreversible damage of ciliary processes in the pigmented rabbits without injury of other ocular tissue.The procedure provides a safe and an effective method for the treatment of glaucoma.