GLAUCOMA FILTERING IMPLANTS

60%接受滤过手术的青光眼患者 与伤口自然愈合相关的并发症。一种常见的短期 并发症是滤过泡在术后2至6个月内堵塞。 做手术。当伤口自然愈合反应时，就会出现这种并发症 太广泛了。因此，在服用抗代谢药物时， 手术控制伤口早期愈合反应。然而，该控件 是不准确的，而且有更高的低眼压风险。一种常见的长期 并发症是术后2-4年滤过泡失败。 由于闭塞的致密的胶原疤痕导致的持续 激活伤口愈合反应。拟议的研究采用了 解决这一问题的聚合物化学和生物医学工程工具 伤口愈合反应的短期和长期控制问题 在过滤现场。这项材料科学研究的目标 项目有1)确定控制释放的最佳参数 抗代谢药物控制伤口愈合；2)评价 伤口愈合反应的长期、低水平激活是一个主要的 青光眼滤过泡晚期失败的原因；以及3)确定 假体植入后是否有多孔细胞植入 表面可以减少植入物的微动，从而 最大限度地减少刺激伤口的长期异物反应 愈合，并可能导致胶原疤痕和纤维包膜增加 变厚了。具体的实验是为了：1)验证 从可生物降解塞罐中控制释放抗代谢物 减少滤过泡中的初始伤口愈合反应 各种类型的青光眼滤过手术；以及2)评估 固定物周围创面的中长期愈合反应 与传统的管状和塞顿板植入物相比。方法包括 荧光光度(房水流动)、组织学(纤维包膜大小和 胶原纤维直径)、免疫组织化学(相对量 巨噬细胞、纤维连接蛋白和成纤维细胞；存在的胶原类型)，非 放射性原位氢化(L和Ill胶原mRNA型)，以及 免疫化学(白介素I)技术。这些研究的结果 将提供对成功所涉及的过程的洞察 滤过手术的失败，以及提供一个潜在的解决方案 复杂性鼻咽癌手术治疗中的相关问题 青光眼。

Sixty percent of glaucoma patients who have filtration surgery encounter complications related to natural wound healing. A common short-term complication is occlusion of the filtering bleb within 2 to 6 months after surgery. This complication occurs when the natural wound healing response is too extensive. Antimetabolite drugs are therefore used at the time of surgery to control the early wound healing response. However the control is inexact and there is increased risk of hypotony. A common long-term complication is failure of the filtering bleb 2 to 4 years after surgery due to occlusion by dense collagen scars which result from the continued activation of the wound healing response. The proposed research employs the tools of polymer chemistry and biomedical engineering to address this problem of short-term and long-term control of the wound healing response at the filtration site. The objectives of this materials science research project are 1) to define the optimum parameters for controlled release of antimetabolite drugs to control wound healing; 2) to evaluate whether long-term, low-level activation of the wound healing response is a major cause of late failure of glaucoma filtering blebs; and 3) to determine whether prosthetic implants with posterior porous cellular ingrowth surfaces can decrease the micromovement of the implants, thereby minimizing the long-term foreign body responses that stimulate wound healing and may lead to increased collagen scars and fibrous capsule thickening. Specific experiments are designed to: 1) verify that controlled release of an antimetabolite from the biodegradable plug can decrease the initial wound healing response in the filtering blebs of various types of glaucoma filtering surgeries; and 2) evaluate the intermediate and long-term wound healing responses around immobilized versus conventional tube and seton plate implants. Methodology includes fluorophotometric (aqueous flow), histologic (fibrous capsule size and collagen fiber diameter), immunohistochemical (relative quantities of macrophages, fibronectin, and fibroblasts; type of collagen present), non- radioactive in situ hydridization (types l and Ill collagen mRNA), and immunochemical (interleukin I) techniques. The results of these studies will provide insight into the processes involved in the success and failure of filtering surgery, as well as provide a potential solution to the problems associated with the surgical treatment of complicated glaucoma.