An Experiment Study On The Application Of Sandwich Amniotic Membrane In Modified Trabeculectomy In Rabbit Model

Objective:TO research glaucoma trabeculectomy in rabbits eyes combined amniotic membrane transplantation,after operation filter corridor and alkaline fibroblast growth factor (b-FGF) and transformation growth factor (TGF-β2) fibrous tissue growth factor (CTGF) andα-smooth muscle actin (α-SMA) expression in the influence of amniotic membrane transplantation, confirmed in practical value trabeculectomy.Method:Healthy adult New Zealand white rabbit, male and female merger,were randomly selected group of rabbits with acute angle-closure glaucoma left eye modiling,after modeling success, random selected 35 left eye acute angle-closure glaucoma mode.after random selected15 rabbit left eye line glaucoma trabeculectomy, joint amniotic membrane transplantation, make up for A group,15 rabbit to do simple left eye glaucoma trabeculectomy group B,5 rabbit for groupC, Respectively on postoperative first Id,3d,14d 7d,28d slit lamp, observed under intraoperative rabbit eyes filtering bleb form, complications and intraocular pressure changes. In postoperative 1d,3d,14d,28d 7d, each group random take 3 rabbit to die, having left eye ball, take surgery filter corridor and surrounding tissue, using formaldehyde solution is fixed, the line HE dyeing and immunohistochemical staining. Light-microscopy filter corridor fibroblasts quantity and proliferation condition and b-FGF, TGF-β2, CTGF positive expression. Observed by immunofluorescense in the operating areaα-SM A expression.Results:1, intraocular pressure:A, B group made before in the mould has significant intraocular pressure difference (p< 0.05). Preoperative and postoperative intraocular pressure also have significant difference (p< 0.05). Postoperative each time point and A, B group had no significant differences between intraocular pressure (P< 0.05).2, filtering bleb:postoperative 1d,3d,7d two groups of filtering bleb are function filtering bleb, postoperative 14dA group5 rabbits had function filtering bleb, the group B 1 rabbits had functional filtering bleb, postoperative 28d A group 3rabbits had function filtering bleb, B group no rabbits had function filtering bleb.the statistical analysis of two groups of functional filtering bleb amount has difference (p <0.05).3. Complications:group B appeared in 3 cases of inflammatory reaction rabbit on 3th day, A group of appear in 1 case shallow anterior chamber in the first week.4. HE dyeing:A group of postoperative 7d filtration area visible small amounts of inflammatory cells infiltrating, amniotic membrane transplantation has seen dissolve, keep intact, and fibroblasts began hyperplasia, filter corridor have A spindle occur around the fibroblasts, filter corridor remains open state; Postoperative 14d filter corridor collagen fibers and around a visible fibroblasts uniform, amniotic membrane transplantation has not completely dissolved, scarring, filter corridor has formed and most remains open state; Postoperative 28 days, the fraction of filter aisle fully formed filter corridor to show off. Group B postoperative 7d filtration area visible large amounts of inflammatory cells infiltrating, fibroblasts start multiplying, filter corridor occur around more than A group of fibroblasts, collagen fiber increased, filter corridor to show opening state; 14d filtration zone after the decrease in the number of inflammatory cells, a large amount of collagen fiber filter corridor, arranging disorderly blockage, scar also has developed, the filter corridor basic remains open state, postoperative 28 days around a filter corridor is the collagen fibers, filter corridor is collagen fiber jams, a few filter corridor to show opening state. 5. Immunohistochemical stains result shows:two groups of postoperative 7d b-FGF, TGF-beta 2, CTGF expression in peak condition, the highest rate of postoperative after 7d gradually declined, group A positive rate of expression below group b, two groups of comparisons significant difference (p< 0.05).6. a-SMA in the A group rate was low the group B.Conclusion:1.Glaucoma trabeculectomy combined amniotic membrane transplantation complications occurred less, can effectively reduce intraocular pressure.2. Glaucoma trabeculectomy can inhibit the combined amniotic membrane transplantation into fiber cell proliferation, make filter corridor scarring degree, keep filter corridor open and functional filtering bleb, improve the success rate.3. the alkaline fibroblast growth factor (b-FGF) and transformation growth factor (TGF-β2), fibrous tissue growth factor (CTGF) after surgery in glaucoma filter corridor of scar formation has certain stimulative effect.4. Glaucoma amniotic membrane transplantation joint trabeculectomy can effectively restrain alkaline fibroblast growth factor (b-FGF) and transformation growth factor (TGF-β2), TGF-fibrous tissue growth factor (CTGF),α-SMA expression.5. Transformation growth factor (TGF-β2) fibrous tissue growth factor (CTGF) in experiments found that there are positive correlation, transforming growth factor (TGF-β2) directly affect the content of CTGF content.