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目的:研究He-Ne激光对兔眼小梁切除术后滤过道瘢痕化的影响及其机制,探讨He-Ne激光在青光眼小梁切除术中的应用价值。方法:于小梁切除手术前采用功率密度200mW/cm2He-Ne激光照射兔眼(右眼)手术区,照射部位选择鼻上象限角膜缘紧邻上直肌处,光斑直径4mm,照射时间10min,1次/d,连续照射3d。最后一次照射后24h实施双眼小梁切除术。手术后第7,14,28d检测手术区组织结缔组织生长因子(connective tissue growth factor,CTGF);第14和第28d检测胶原密度(masson染色)。左眼设为单纯手术对照组。每时间点各7只兔。结果:手术后第7,14d,He-Ne激光组CTGF表达较对照组减少(P=0.01;P=0.005)。手术后第14,28dHe-Ne激光组胶原密度显著低于对照组(P=0.013;P=0.01)。结论:功率密度200mW/cm2He-Ne激光预照射小梁切除术手术区域,可下调术后该区域成纤维细胞CTGF表达并减少胶原合成,可能有助于减少兔眼小梁切除术后滤过道瘢痕形成。He-Ne激光有可能为预防青光眼滤过手术后瘢痕化提供新的方法。
Objective: To study the effect and mechanism of He-Ne laser on cicatricial scarring after trabeculectomy in rabbits and to explore the value of He-Ne laser in trabeculectomy of glaucoma. Methods: The rabbit eye (right eye) was irradiated with 200 mW / cm2 He-Ne laser before trabeculectomy. The upper quadrant of the upper quadrant was selected at the irradiation site. The spot diameter was 4 mm and the irradiation time was 10 min. Times / d, continuous irradiation 3d. Bilateral trabeculectomy was performed 24h after the last irradiation. At the 7th, 14th and 28th day after operation, the connective tissue growth factor (CTGF) was detected in the operation area. The collagen density (masson staining) was detected on the 14th and 28th day. Left eye as a simple surgical control group. Seven rabbits at each time point. Results: On the 7th and 14th day after surgery, the CTGF expression in He-Ne laser group was lower than that in the control group (P = 0.01; P = 0.005). The collagen density of He-Ne laser group was significantly lower than that of the control group on the 14th and 28th day after operation (P = 0.013; P = 0.01). CONCLUSION: Pre-irradiation of trabeculectomy with 200 mW / cm2 He-Ne laser with a power density can down-regulate the expression of CTGF in the fibroblasts and reduce the collagen synthesis in the area, which may be helpful to reduce the scar in the trabecular meshwork after trabeculectomy form. He-Ne lasers may offer new ways to prevent scarring after glaucoma filtration surgery.