A Thin Honeycomb-patterned Film as an Adhesion Barrier in an Animal Model of Glaucoma Filtration Surgery
A Thin Honeycomb-patterned Film as an Adhesion Barrier in an Animal Model of Glaucoma Filtration Surgery
复制标题
DOI：
10.1097/ijg.0b013e31817eee32
复制
发表时间：
2009-03-01
影响因子：
2
通讯作者：
Sugiyama, Kazuhisa
中科院分区：
文献类型：
--
作者：
Okuda, Tetsuhiko;Higashide, Tomomi;Sugiyama, Kazuhisa
目的：评价蜂窝状生物可降解薄膜用于兔青光眼滤过手术的有效性和安全性。方法：将7亩厚的L-丙交酯-乙交酯-己内酯共聚物薄膜放置于兔单眼结膜下间隙。做或不做全层滤过手术。膜的表面呈蜂窝状，面向结膜下Tenon组织，另一面光滑。另一只眼也进行了滤过手术，未接受任何辅助治疗或接受0.4 mg/mL丝裂霉素C(MMC；n=6)治疗。术后28天定期测量眼压和超声生物显微镜评估滤过泡，并进行组织学观察。结果：术后第10天至28天，薄膜处理组的眼压明显低于对照眼(P<；0.05)，但与丝裂霉素C组相比差异无统计学意义。超声生物显微镜检查5只对照眼、1只丝裂霉素组结膜下滤过间隙消失，而膜组无一例消失。2只接受丝裂霉素C治疗的眼发生滤过泡漏。组织学上，在未做滤过手术的眼睛中，蜂窝状的一侧可见部分附着有膜的纤维组织，但面对膜的光滑一侧的巩膜上的纤维化组织很少。结论：在兔青光眼滤过手术中，附着于滤过泡内壁的蜂窝状薄膜起到了粘连屏障的作用，值得进一步研究。
Purpose: To evaluate the effectiveness and safety of a thin honeycomb-patterned biodegradable film for glaucoma filtration surgery in rabbits.Methods: A 7 mu m-thick film made from poly(L-lactide-co-epsilon-caprolactone) was placed in the subconjunctival space in one eye of rabbits. with or without full thickness filtration surgery. The film had a honeycomb-patterned surface that faced the subconjunctival Tenon tissue and the other side was smooth. Filtration surgery was also performed in the fellow eye, which received either no adjunctive treatment or 0.4 mg/mL mitomycin C (MMC; n = 6 each). Intraocular pressure (IOP) measurements and bleb evaluations using ultrasound biomicroscopy were performed periodically for 28 days after surgery followed by histologic observation.Results: Postoperative IOPs of the film-treated eyes were significantly lower than that of control eves from day 10 to day 28 (P < 0.05), but were not significantly different from those of MMC-treated eyes. The subconjunctival filtration space, detected by ultrasound biomicroscopy, disappeared in 5 control eyes, 1 MMC-treated eye, but none of the film-treated eyes. A bleb leak occurred postoperatively in 2 MMC-treated eyes. Histologically, in eyes without filtration Surgery, fibrotic tissue with the film partly attached to it was noted on the honeycomb side, but was minimal on the sclera that faced the smooth side of the film. In eyes with filtration surgery, the honeycomb-patterned film lined the inner bleb wall with minimal inflammatory reaction.Conclusions: The thin honeycomb-patterned film that attached to the inner bleb wall worked as an adhesion barrier in glaucoma filtration Surgery in rabbits, which is worthy of further investigation.