导航360°Schlemm管手术的新型荧光纤维构建及其临床前关键实验研究

青光眼是全球第一位不可逆性致盲性眼病。目前治疗青光眼最前沿、最有效的方法之一是360°Schlemm管手术，其关键和难点为穿过全周Schlemm管，但缺乏简便、易普及的穿管方法。我们研究发现，负载有量子点的海藻酸钠水凝胶荧光纤维与聚丙烯缝线的力学性能类似，可穿过部分Schlemm管并透过巩膜可视。基于此，本项目拟制备可通过手术显微镜自身光源激发发出红光、“可视化”导航穿过全周Schlemm管的新型功能化荧光纤维。通过建立兼具手术导航及活体成像功能的荧光纤维的可控制备方法，制备修饰有光切荧光探针的荧光纤维并优化其性能；在细胞和动物层面，通过PCR、免疫组化等方法，系统研究荧光纤维的手术导航及活体成像效果；阐明材料性能与手术效果的内在联系，利用活体成像技术探讨发病机制。本项目旨在为新型荧光纤维的临床转化奠定理论和实验基础，为360°Schlemm管手术及青光眼的发病机制研究提供新思路。

Glaucoma is the first leading reason for irreversible blindness in the world. At present, one of the most advanced and effective treatments for glaucoma is 360-degree Schlemm’s canal surgery. The key and difficulty of the surgery are to pass through the whole Schlemm’s canal. But there is a lack of simple and popular methods. We found that the fluorescent fiber of sodium alginate hydrogel loaded with quantum dots exhibited mechanical properties similar to those of polypropylene sutures. The fiber passed through part of the Schlemm’s canal and could be seen through the sclera. Therefore, this project is designed to prepare a novel functionalized fluorescent fiber that can emit red light by the light of the operating microscope itself, and visually guide the canalization of the whole Schlemm’s canal. By establishing a controllable method for the preparation of a fluorescent fiber with both surgical navigation and in vivo imaging functions, a fluorescent fiber modified with light-sectioning fluorescent probes is prepared and their properties are optimized. At the cell and animal levels, the surgical navigation and in vivo imaging effects of the fluorescent fiber are systematically studied by PCR, immunohistochemistry, and other methods. This project aims to elucidate the internal relationship between material properties and surgical results and to explore the pathogenesis by using in vivo imaging technology. This project aims to lay the theoretical and experimental foundation for the clinical transformation of the novel fluorescent fiber and provide a new idea for 360-degree Schlemm's canal surgery and the pathogenesis of glaucoma.