目的:本研究的目的是研究CS-g-MMCs缀合物(CSM)是否可能是预防实验性青光眼滤过手术兔模型术后纤维化的新药物。
方法:在随机分组中,控制,蒙面观察者研究,40只新西兰白兔右眼行小梁切除术,随机接受结膜下注射磷酸盐缓冲盐水,壳聚糖(CS),CSM(100µg/ml),CSM(200µg/ml)或丝裂霉素C(100µg/ml)。通过裂隙灯检查评估气泡特征和前房深度。在第14天和第28天处死动物。进行组织病理学和免疫组织化学以确定瘢痕形成和纤维化的量。通过组织病理学和电子显微镜评估眼毒性。
结果:我们发现五组在眼压和前房深度方面相似。在PBS中存活天数的中位数为:5.5、8、17.5、28和16,CS,CSM100、CSM200和MMC组,分别。CSM200和MMC组均显示出比CSM100,CS和PBS组明显更大的气泡面积。CSM200和MMC组在第14天和第28天的瘢痕形成少于PBS,CS和CSM100组经由过程组织学和免疫组织化学考核。各组兔眼均未发现损伤。
结论:结膜下注射CSM可提高兔模型滤过泡的存活率。它可以是青光眼手术中安全有效的抗代谢物。
OBJECTIVE: The aim of this study is to investigate whether CS-g-MMCs conjugate (CSM) could be a new agent to prevent the post-operative fibrosis in a rabbit model of experimental glaucoma filtration surgery.
METHODS: In a randomized, controlled, masked-observer study, 40 New Zealand White rabbits underwent trabeculectomy in the right eyes and randomly received subconjunctival injection of phosphate buffered saline, chitosan (CS), CSM (100 µg/ml), CSM (200 µg/ml) or Mitomycin C (100 µg/ml). Bleb characteristics and anterior chamber depth were evaluated by slit-lamp examination. The animals were killed on day 14 and 28. Histopathology and immunohistochemistry were performed to determine the amount of the scarring and fibrosis. Ocular toxicity was assessed by histopathology and electron microscope.
RESULTS: We found that the five groups were similar with respect to intraocular pressure and anterior chamber depth. The medians for survival days were: 5.5, 8, 17.5, 28 and 16 in the PBS, CS, CSM100, CSM200 and MMC groups, respectively. Both the CSM200 and the MMC group showed a significantly larger bleb area than the CSM100, CS and the PBS group. Less scarring was seen on day 14 and 28 in CSM200 and MMC group than in the PBS, CS and CSM100 group by histology and immunohistochemistry assessment. No damages were found in the rabbit eyes in each group.
CONCLUSIONS: Subconjunctival injection of CSM postoperatively can improve the filtration bleb survival in the rabbit model. It can be a safe and effective
antimetabolite in glaucoma surgery.