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目的观察结膜瓣下西罗莫司载药羊膜植入在兔眼小梁切除术中应用的效果。方法新西兰白兔32只(64眼),全麻下前房注入2%甲基纤维素制成高眼压模型。实验眼分成4组,每组16眼,在施行小梁切除时,分别行羊膜植入(A组),西罗莫司载药羊膜植入(B组),丝裂霉素C(C组),未使用任何药物(D组)。术后观察眼压、滤过泡、并发症等情况。结果①术后90d眼压:A组(18.23±3.90)mmHg(1mmHg=0.133kPa),B组(13.18±2.24)mmHg,C组(14.98±3.33)mmHg,3组眼压值均显著低于D组的(25.01±1.23)mmHg(t分别为4.132;6.487;5.986,P<0.05);但A组眼压值较C组(阳性对照)高,差异有统计学意义(t=2.794,P<0.05);②术后90d具有功能性滤过泡者:A组12眼(12/16,75%);B组15眼(15/16,93.75%);C组14眼(14/16,87.5%),前3组与D组8眼(8/16,50%)相比,功能性滤过泡数差异均有统计学意义(χ2分别为4.907;6.596;5.162,P<0.05);③并发症:除C组2眼发生脉络膜脱离外,其余各组均未发生此并发症。结论西罗莫司载药羊膜植入能提高兔眼小梁切除术的成功率且无明显的手术并发症。
Objective To observe the effect of amniotic membrane implantation of amlodipine on the trabeculectomy in rabbits under subconjunctival flap. Methods 32 New Zealand white rabbits (64 eyes) underwent an intraocular pressure (IOP) model by injecting 2% methylcellulose into the anterior chamber under general anesthesia. The experimental eyes were divided into 4 groups with 16 eyes in each group. Amniotic membrane implantation (group A), amniotic membrane implantation with sirolimus (group B), mitomycin C (group C) ), Did not use any drug (group D). Postoperative intraocular pressure, filtration bleb, complications and so on. Results ① The intraocular pressure at 90 days after operation was significantly lower than that in group A (18.23 ± 3.90) mmHg (1mmHg = 0.133kPa), group B (13.18 ± 2.24) mmHg and group C (14.98 ± 3.33) mmHg (25.01 ± 1.23) mmHg (t = 4.132; 6.487; 5.986, respectively, P <0.05) in group D, while the intraocular pressure in group A was significantly higher than that in group C (positive control) (P <0.05). ② The patients with functional filtering bleb 90 days after operation were: 12 eyes in group A (12/16,75%), 15 eyes in group B , 87.5% respectively). There were significant differences in the number of functional filtration bleb between the first 3 groups and the 8th group (8/16, 50%) in group D (χ2 = 4.907; 6.596; 5.162, ; ③ complications: in addition to C group 2 choroidal detachment, the rest of the group did not happen this complication. Conclusion Amniotic membrane implantation of sirolimus can improve the success rate of rabbit trabeculectomy without obvious complications.