【摘要】 目的比较前房穿刺法和植管法建立的2种大鼠青光眼滤过手术模型,并观察术后眼压和结膜滤过泡情况及术后结膜瘢痕形成过程。方法将30只SD大鼠分为穿刺组和植管组,其中穿刺组15只15眼采用穿刺法,植管组15只15眼采用植管法。分别于术前及术后3 d、1周、2周、4周检测大鼠眼压,观察手术区结膜及角膜组织的充血水肿情况、前房情况及滤过泡形态变化,并记录滤过泡维持时间及生存率;术后4周分别摘取2组大鼠眼球制作石蜡切片,行HE染色、苦味酸狼红染色观察结膜切口的愈合情况及瘢痕形成。结果 2组术后3 d眼压均明显低于术前; 2组平均眼压比相比,仅术后1周差异具有统计学意义(P <0.05),术后3 d、2周、4周差异均无统计学意义(P> 0.05)。穿刺组术后1周滤过泡形态扁平,术后2周几乎观察不到;植管组术后1周滤过泡隆起较穿刺组明显,术后2周滤过泡逐渐局限,结膜组织包裹PE管末端,术后4周仅观察到滤过区结膜组织包裹PE管末端。穿刺组滤过泡维持时间为3～5 d,平均(3.5±0.64) d;植管组为10～14 d,平均(12.5±1.85) d。滤过术后1周植管组滤过泡的生存率(26.25±3.25)%高于穿刺组的(10.50±1.86)%,差异具有统计学意义(P <0.05)。术后4周组织切片染色显示,2组手术区结膜组织均可见大量胶原组织沉积,而植管组术区结膜组织明显较厚。结论大鼠前房穿刺法与植管法均可成功建立青光眼滤过手术动物模型,且植管法更有利于观察滤过泡形态及瘢痕形成,可用于青光眼术后抗瘢痕相关研究。更多还原

【Abstract】 Objective To compare the establishments of two different models of glaucoma filtering surgery in rats by the anterior chamber puncturation and catheterization,and observe the postoperative intraocular pressure,conjunctival filtering blebs and postoperative conjunctival scar formation process. Methods Totally 30 SD rats were divided into the puncturation group and catheterization group,15 rats with 15 eyes were included in the puncturation group and 15 rats with 15 eyes were included in the catheterization group. Intraocular pressure were measured before operation and 3 days,1 week,2 weeks and 4 weeks after operation. The hyperaemia and oedema of the conjunctiva and corneal tissue in the operation area,anterior chamber conditions,and morphological changes of the conjunctival filtration bleb were observed and the holding time and survival rate of filtration blebs were recorded. The eyeballs of rats in the two groups were taken and made into paraffin sections 4 weeks after surgery and the conjunctival incision healing and scar formation were observed by hematoxylin and erosin( HE) staining and picrosirius red staining. Results The intraocular pressures in both two groups 3 days after operation were significantly lower than those before operation. There was statistically significant difference in the mean intraocular pressure ratio 1 week after operation between the two groups( P < 0. 05),but no significant difference was found 3 days,2 weeks and 4 weeks after operation between the two groups( P > 0. 05). In the puncturation group,the shape of the filtration blebs was flat after 1 week,but almost no filtration bleb was observed after 2 weeks. In the catheterization group,the bulging filtration blebs were more obvious than those in the puncturation group but gradually limited 2 weeks after operation with the end of PE tube wrapped by conjunctival tissues,and only the conjunctival tissues in the filtering area were observed to wrap the end of the PE tube 4 weeks after operation. The holding time of the filtration blebs in the puncturation group was 3 to 5 days,with an average of( 3. 5 ± 0. 64) days,and that in the catheterization group was 10 to14 days,with an average of( 12. 5 ± 1. 85) days. The survival rate of filtration blebs in the catheterization group 1 week after operation was( 26. 25 ± 3. 25) %,which was higher than that in the puncturation group( 10. 50 ± 1. 86) %,the difference was statistically significant( P < 0. 05). The tissue slices staining showed that a large amount of collagen tissues deposition was observed in the conjunctival tissue of the operation area in both two groups,while the conjunctival tissues in the catheterization group was significantly thicker. Conclusion Both anterior chamber puncturation and catheterization method can successfully establish the glaucoma filtering surgery animal model,and the catheterization method can be more conducive to observe the shapes and scar formation of filtration blebs and can be used for the anti-scarring study after glaucoma surgery.更多还原