应用滤过性手术在大鼠眼上建立结膜滤过泡瘢痕化模型的研究

目的探讨应用滤过性手术在大鼠眼上建立结膜滤过泡瘢痕化模型的可行性。方法选用35只健康成年SD大鼠作为实验动物,在全身麻醉下行单侧眼球滤过性手术,术后观察结膜滤过泡的形成情况,并观察眼前节反应;手术后1、3d,1、2、4周共5个时间点各处死3只大鼠,摘除其眼球,常规10％福马林固定,切片,HE染色,观察其病理改变,并以对侧眼作为正常对照。结果所有大鼠在手术后7d均有结膜滤过泡形成;手术后8d,结膜滤过泡消失,最长的结膜滤过泡能够维持21d。组织病理学观察显示,术后1d,结膜下组织疏松水肿,血管扩张、充血明显,有较多中性粒细胞浸润;术后3d,结膜下组织血管扩张、充血,除有中性粒细胞浸润外,还可见单核巨噬细胞浸润,结缔组织疏松、水肿较前减轻;术后7d,血管扩张充血程度较术后3d时减轻,有较多的纤维母细胞增生,纤维母细胞的细胞核呈椭圆形、胞质丰富,在纤维母细胞周围,可见少量疏松的胶原纤维形成;术后2周,纤维母细胞数量较术后1周时有所减少,细胞变细长,细胞核两端变尖,周围胶原纤维较术后1周时致密;术后4周时,结膜下组织血管多数闭合,细胞成分明显减少,纤维母细胞演变为纤维细胞,细胞核变细长,周围伴大量胶原纤维沉积,呈现瘢痕样改变。结论应用滤过性手术在大鼠眼上建立结膜滤过泡瘢痕化模型具有可行性,其病理改变是一个创伤修复的过程,该模型的建立不仅为青光眼手术后结膜滤过泡瘢痕化的防治,同时也为防治其他原因导致的结膜瘢痕化提供了新的研究方法。

Study on a rat model of filtering bleb scarring formation

Objective To investigate a rat animal model of filtering bleb scarring formation. Methods Thirty-five of Sprague-Dawley (SD) rats were used in this experiment. The filtration surgery was performed on one eye of each rat and the other eye served as control. The presence of postoperative bleb and clinical manifestation was evaluated. Each group of three rats were sacrificed and the eyes enucleated on day 1, 3, 7, 14, and 28. After the eyes were fixed by 10% formalin, serial paraffin sections of three eyes were labeled with HE staining and the pathological morphology was observed under a microscope. Results A conjunctival bleb was successfully formed in 35 rats lasting from 8 to21 days after surgery. An obvious dilatation of blood vessels, infiltration of a great number of neutrophil, and a severe edema of the subconjunctival tissue were observed on day 1 and the above morphological changes plus increased infiltration of macrophages were found on day 3. The dilated blood vessels were lessened while the proliferation of fibroblast was presented with abundant endochylema in oval-shaped nucleus of fibroblasts, which were closely associated with the deposition of small amount of new loose collagen fibers on day 7. The collagen fibers became tight on day 14 and subsequently, the early scar was formed on day 28. Conclusion The rat model of filtering bleb scarring formation may be useful for the investigation of preventing and treating conjunctival scarring resulted from glaucoma filtration surgery and other related eye diseases in the future.