生物羊膜在兔非穿透性小梁切除术中的实验研究

目的探讨生物羊膜植入在兔非穿透性小梁切除术（NPTS）中的抗瘢痕作用。方法选取新西兰白兔14只28眼,每只兔双眼均行非穿透性小梁切除术,随机选取1眼,将4mm×12mm生物羊膜植入巩膜瓣和结膜瓣下（实验组）,另一只眼为对照组。观察术后结膜、角膜、前房及滤过泡情况;并于术后10、20d分别处死4、10只白兔取眼球手术区组织HE染色,于光镜、电镜下观察瘢痕形成情况。结果术后10d实验组12只眼（85.2%）见弥散的滤过泡,对照组9只眼（64.3%）见滤过泡,2组比较差异无统计学意义（P〉0.05）;术后20d,实验组8只眼（80.0%）有滤过泡,对照组2只眼（20.0%）有滤过泡,2组比较差异有统计学意义（P〈0.05）;组织学检查显示：实验组滤过区纤维组织明显减少,术后20d仍有空腔存在;对照组滤过区见大量纤维瘢痕组织形成,术后20d滤过腔基本消失。结论生物羊膜在兔眼NPTS中有抗瘢痕作用,为临床应用提供动物实验基础。

Experimental Study of Non-penetrating Trabecular Surgery with Biological Amniotic Membrane in Rabbits

Objective To investigate the anti-cicatricial effect of non-penetrating trabecular surgery （NPTS） with biological amniotic membrane implant in rabbit eyes. Methods Twentyeight eyes of 14 rabbits underwent NPTS. One eye of each rabbit was randomly selected to implant 4 mm×12 mm biological amniotic membrane under the seleral flap and conjunctiva flap, and the other eye served as the control. The conjunctiva,cornea,anterior chamber and filtering bleb were observed after operation. The conditions of scar development were observed with HE pigmentation under the light and electron microscope at the 10th and 20th day after surgey. Results The reaction of cornea coujunctiva, anterior chamber were little. 12 blebs （85.2 %） and 9 blebs （64.3%）were found in amniotic membrane group and control group at 10th day after operation, respectively,but there was no statistically difference between the two groups （P〉0.05）. 8 blebs （80.00%） and 2 blebs （20. 0%） existed in amniotic membrane group and control group at 20th day after operation, respectively, and there was significant difference between the two groups（P〈0.05）. The histological observation showed that scar formation decreased significantly and the blebs were still existed in amniotic membrane group at 20th day after operation. The control group showed more fibroplasia and fibroblast hyperplasia, and the blebs almost disappeared at 20th day after operation. Conclusion Biological amniotic membrane could inhibit the scar formation in NPTS,and the study provided the experimental basis for clinical application of biological amniotic membrane.