Preclinical Investigation of Ab Interno Trabeculectomy Using a Novel Dual-Blade Device
Preclinical Investigation of Ab Interno Trabeculectomy Using a Novel Dual-Blade Device
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DOI：
10.1016/j.ajo.2012.09.023
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发表时间：
2013-03-01
影响因子：
4.2
通讯作者：
Kahook, Malik Y.
中科院分区：
文献类型：
--
作者：
Seibold, Leonard K.;Soohoo, Jeffrey R.;Kahook, Malik Y.
目的：评价新型小梁切除术装置对人眼小梁网的影响。设计：实验室评价。方法：采用3种手术器械：(1)新型双片式小梁切割器；(2)微玻璃体视网膜(MVR)刀；(3)小梁刀。组织标本进行组织学处理和比较分析。随后，进行了人眼灌注研究，以评估每种装置的降低眼压(IOP)的效果。主要观察指标为组织学测量TM的去除程度和灌注模型中的眼压。结果：MVR刀片对TM的去除最小，对邻近巩膜有明显的损伤。小梁切割器切除了TM中央的很大一部分，但残留组织的小叶保留了下来，所有样本都注意到了热损伤。双刀片装置在不损伤周围组织的情况下，实现了TM的更完全去除。在灌流模型研究中，所有装置均能显著降低眼压。在TM的170.0+/-14.1度范围内，MVR刀片治疗导致眼压从18.5+/-1.9毫米汞柱下降到12.8+/-2.2毫米汞(P<；0.01)。小梁切除术后，眼压从18.8±-1.7 mm Hg降至11.3±-1.0 mm Hg(P<；0.01)。通过157.5+/-26.3度的双叶装置治疗，眼压从18.3+/-3.0 mm Hg降至11.0+/-2.2 mm Hg(P<；0.01)。结论：在人眼灌流模型中，这种新型双叶装置可以更彻底地去除TM，而不会残留TM叶或对周围组织造成损害，并显著降低眼压。《眼科杂志》2013；155：524-529。(C)2013年由Elsevier Inc.保留所有权利。)
PURPOSE: To evaluate the effects of a novel ab interno trabeculectomy device on human trabecular meshwork (TM).DESIGN: Laboratory evaluation.METHODS: The TM from human cadaveric corneal rim tissue was incised using 3 instruments: (1) novel dual-blade device; (2) microvitreoretinal (MVR) blade; and (3) Trabectome. Tissue samples underwent histologic processing and comparative analyses. Subsequently, human eye perfusion studies were performed to evaluate intraocular pressure (IOP)-lowering effects of each device. Main outcome measures were degree of TM removal by histology and IOP in a perfusion model.RESULTS: The MVR blade exhibited minimal removal of TM and obvious injury to the adjacent sclera. The Trabectome removed a large portion of the central TM, but leaflets of residual tissue remained and thermal injury was noted in all samples. The dual-blade device achieved a more complete removal of TM without injury to surrounding tissues. All devices resulted in statistically significant lowering of IOP during perfusion model studies. MVR blade treatment across 170.0 +/- 14.1 degrees of TM resulted in a decrease of IOP from 18.5 +/- 1.9 mm Hg to 12.8 +/- 2.2 mm Hg (P < .01). Trabectome treatment across 117.5 +/- 12.6 degrees resulted in a decrease of IOP from 18.8 +/- 1.7 mm Hg to 11.3 +/- 1.0 mm Hg (P < .01). Dual-blade device treatment across 157.5 +/- 26.3 degrees resulted in a decrease of IOP from 18.3 +/- 3.0 mm Hg to 11.0 +/- 2.2 mm Hg (P < .01).CONCLUSIONS: The novel dual-blade device demonstrated a more complete removal of TM without residual TM leaflets or damage to surrounding tissues and significantly reduced IOP in a human eye perfusion model. (Am J Ophthalmol 2013;155:524-529. (C) 2013 by Elsevier Inc. All rights reserved.)