The comparative benefits of glaucoma filtering surgery with an electric-pulse targeted drug delivery system demonstrated in an animal model.
The comparative benefits of glaucoma filtering surgery with an electric-pulse targeted drug delivery system demonstrated in an animal model.
复制标题
DOI：
10.1016/s0161-6420(99)90249-x
复制
发表时间：
1999-06
期刊：
影响因子：
13.7
通讯作者：
Y. Oshima;T. Sakamoto;T. Nakamura;Y. Tahara;Y. Goto;T. Ishibashi;H. Inomata
中科院分区：
文献类型：
--
作者：
Y. Oshima;T. Sakamoto;T. Nakamura;Y. Tahara;Y. Goto;T. Ishibashi;H. Inomata
目得：目的评价博来霉素联合电脉冲（EP）持续应用在青光眼滤过手术中的安全性和有效性。设计：家兔实验研究。控制和方法：对有色兔进行小梁切除术（2 - 2.5 kg），使用以下连续处理：5 μM局部博莱霉素和EP（5V，50 msec，8脉冲）A组：B+E+，n=15（B组：B+E-，n=15）; 5 μM丝裂霉素C（MMC）和EP C组：M+E+组（n=10）; D组：M+E-组（n=10）; E+组（n = 10）;主要观察指标：术后60天定期测量眼压。还定期评价滤过泡形成以及结膜、角膜和视网膜的状况。光镜下进行组织学研究，视网膜电图评价视网膜功能。结果：所有动物的术后IOP均显著低于术前水平，直至第7天。然而，E和F组（阴性对照）在第7天后恢复到术前水平，B、C和D组在15天后恢复到术前水平。A组的IOP甚至在第40天仍保持较低。第20天，A组IOP降低或升高的平均值为−6.4 mmHg（P < 0.05）; B组为−0.2 mmHg; C组为+1.2 mmHg; D组为−3.25 mmHg。A组术后20 d滤过泡存活率明显高于其他各组。临床和组织学研究未发现任何眼内或眼旁组织的病理学发现。A组视网膜功能的视网膜电图评价显示在60天的研究中没有明显变化。结论：在兔青光眼滤过手术中连续使用博莱霉素联合EP可显著降低IOP长达40天，而不会在临床、形态学或功能上损害眼内组织。
PURPOSE: To evaluate the safety and effectiveness of glaucoma filtering surgery performed with the adjunctive use of bleomycin administered in conjunction with electric pulses (EP). DESIGN: Experimental study in rabbits. CONTROLS AND METHODS: Trabeculectomies were performed on pigmented rabbits (2 to 2.5 kg) using the following adjunctive treatments: 5 μM of topical bleomycin and EP (5V, 50 msec, 8 pulses) (group A: B+E+, n=15); bleomycin but no EP (group B: B+E-, n=15); 5 μM mitomycin C (MMC) and EP (group C: M+E+, n=10); MMC but no EP (group D: M+E-, n=10); EP alone (group E: E+, n=10); and no adjunctive treatment (group F: E-, negative control, n=10). MAIN OUTCOME MEASURES: Intraocular pressure (IOP) was measured regularly for 60 days after the operation. Bleb formation and the condition of the conjunctiva, cornea, and retina were also regularly evaluated. Histologic studies were performed by light microscopy, and retinal functions were evaluated by electroretinography. RESULTS: Postoperative IOP was significantly lower than the preoperative level in all the animals until day 7. However, in groups E and F (the negative control) it returned to the preoperative level after day 7, and in groups B, C, and D after 15 days. The IOP of group A remained lower even on day 40. The average amount IOP was lowered or increased on day 20 was −6.4 mmHg (P < 0.05) in group A; −0.2 mmHg in group B; +1.2 mmHg in group C; and −3.25 mmHg in group D. The survival rate of the filtering blebs on day 20 was significantly higher in group A than in the other groups. Clinical and histologic studies uncovered no pathologic findings in any intra- or paraocular tissues. Electroretinographic evaluation of retinal function in group A showed no apparent change over the 60 days of the study. CONCLUSION: Glaucoma filtering surgery in rabbits with the adjunctive use of bleomycin in conjunction with EP significantly lowered IOP for up to 40 days without clinically, morphologically, or functionally harming intraocular tissues.