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目的探讨细胞外间质(ECM)植入对小梁切除术后滤过泡和眼压的影响。方法将40只白兔右眼制备青光眼动物模型,随机分为对照组和ECM组,每组20只。对照组行单纯小梁切除术,ECM组行小梁切除术联合结膜ECM植入。术后1至16周观察滤过泡形态及功能并测量眼压,进行统计学分析,光学显微镜下观察滤过泡下组织细胞形态。结果术前平均眼压:对照组(35.11±4.32)mmHg,ECM组(35.18±4.37)mmHg,术后1、2、3、4、6、8、10、12、16周眼压两组比较均有显著性差异(P<0.01)。裂隙灯观察:ECM组比对照组术后滤过泡有较好滤过功能。组织学观察:ECM组比对照组滤过泡区成纤维细胞少,未见瘢痕组织形成。结论结膜ECM植入能改善小梁切除术后滤过泡功能,减少瘢痕形成,并能良好地控制眼压。小梁切除术联合结膜ECM植入有希望成为治疗青光眼的安全、有效的新方法。
Objective To investigate the effect of extracellular matrix (ECM) implantation on postoperative filtering bleb and intraocular pressure (IOP) after trabeculectomy. Methods 40 white rabbits were used to prepare the glaucoma model in the right eyes of rabbits. They were randomly divided into control group and ECM group, 20 in each group. The control group received simple trabeculectomy, ECM group trabeculectomy combined with conjunctival ECM implantation. The morphology and function of the bleb were observed 1 to 16 weeks after operation and the intraocular pressure was measured. Statistical analysis was performed under light microscope to observe the morphology of the cells under filtration. Results The average preoperative IOP was 35.11 ± 4.32 mmHg in the control group, 35.18 ± 4.37 mmHg in the ECM group, and 1, 2, 3, 4, 6, 8, 10, 12 and 16 weeks after the operation There was significant difference (P <0.01). Slit lamp observation: The ECM group had better filtration function than the control group. Histological observation: ECM group than the control group less bleb fibroblasts, scar tissue was not seen. Conclusions Conjunctival ECM implantation can improve the filtering bleb function after trabeculectomy, reduce scar formation and control intraocular pressure well. Trabeculectomy combined with conjunctival ECM implantation is promising as a safe and effective new method for the treatment of glaucoma.