| OBJECTIVE TO explore anti-scaring effect of lmwh after glaucoma trabeculectomy in a rabbit model Methods: Trabeculectomy were performed on 54 eyes of 27 New Zealand White rabbits which were randomly divided into three groups:control groups,expermental groupâ… and expermental groupâ…¡,18 eyes of 9 rabbits in each group.Subconjunctival injections of one of three materials were made:0.5ml PBS in control group,5IU/mL LMWH (0.5 mL) in experimental groupâ… ,50 IU/mL LMWH (0.5 mL) in experimental groupâ…¡at the end of operation and 1 day after surgey. Filtration bleb, corneal epithelium, conjunctival wound, anterior chamber reaction and hyphema were observed by slitlamp on 3,7,14,28 days after surgery, recording the complications of each group and comparing the percentage of the functional bleb. Intraocular pressure(IOP) measurements were performed preoperation and on postoperative days 3,7,14,28 respectively. Two rabbits selected randomly in every group were killed on days 3,7,14,28 day after surgery. Conjunctiva and sclera of filtering area of the rabbits were fixed by 4% formalin, then were embedded with paraffin. Newborn collagen fibers through masson staining and proliferation of fibroblast were observed by immunohistochemistry staining of proliferative cell nuclear antigen(PCNA). All the data were analyzed by software of SPSS 13.0 for windows.Results: (1) IOP There were no difference among three groups on preoperation and 3 day postoperation(P>0.05). There was also no significant difference between experimental groupâ… and control group on days 7,14,28 postoperative. But diference was significant between experimental groupâ…¡and the other two groups on days 7,14,28 postoperative (P<0.05).(2) Filtration bleb They were all for functional filtration bleb on day 3 postoperation in ervey group. There was one non-functional bleb in control group and experimental groupâ… respectively on day 7 postoperation. In experimental groupâ…¡, all are functional bleb. The percentage of functional bleb in experimental groupâ…¡was higer than that in experimental groupâ… and control group.(3) Complication On day 3 postoperation, there was one eye with corneal epithelium damage in experimental groupâ… .No case was with conjunctival wound leak.There was one shallow anterior chamber in control group and experimental group respectively,which recovered on day 7 postoperation. One case with hyphema was observed in experimental groupâ…¡, which was absorbed completely on day 7 postoperation .(4) Masson stainning There were all for newborn collagen fibers in filtering channel of every group.There were significant difference of newborn collagen fibers among the three groups( P<0.05). The number of newborn collagen fibers in experimental groupâ…¡was less than that in experimental groupâ… and control group, but no significant difference between experimental groupâ… and control group(P>0.05) .(5) Immunohistochemistry staining There was more positive cells in control group, significant difference among three groups on day 3 postoperation(P<0.05).On day 7,14.28 postoperation, there were no significant differences of the numbers of PCNA-staining positive cell between the experimental groupâ… and control group(P>0.05).The numbers of positive cells in experimental groupâ…¡was less than those in control group(P<0.05).Conclusion: (1) LMWH can inhibit the proliferation of fibroblast and collagen fiber.(2) There were no significant side effect in eye.(3) LMWH can maintain durable and stable iop and functional bleb,which may improve the success rate in glaucoma surgery.
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