睫状体平坦部滤过术房水引流途径的研究  

Experimental study on the outflow pathways of Pars Plana Filtration Technique for glaucoma surgery

作　　者：唐由之[1] 王影[1] 

机构地区：[1]中国中医科学院眼科医院,北京100040

出　　处：《中国中医眼科杂志》2011年第4期187-190,共4页China Journal of Chinese Ophthalmology

基　　金：国家自然科学基金面上项目(编号:30672711)

摘　　要：目的通过对睫状体平坦部滤过术后房水引流途径的观察,探讨该手术降低眼压的机制。方法利用前房注入异硫氰酸荧光素牛血清白蛋白(FITC-BSA)的方法对兔眼卡波姆模型手术组(A组)、单纯手术组(B组)手术后及正常对照组(C组)兔眼进行荧光强度的观察。结果 FITC-BSA注射后2h,A组和B组的前部结膜和房水池有耀眼荧光,而C组该部分组织无荧光;FITC-BSA注射后6h,A、B组结膜和房水池部位仍有明亮荧光,其他各部位荧光均有不同程度减弱,C组在睫状体和脉络膜上腔可见明亮荧光;FITC-BSA注射后10h,A、B2组结膜和睫状体、A组后巩膜、C组睫状体、脉络膜上腔和前巩膜可见少量荧光。此时3组其他部位无荧光。结论睫状体平坦部滤过术后房水经3个途径回流:①房水经滤过口引流至结膜下,结膜血管将房水吸收;②房水经前房角,进入睫状体外侧和巩膜内侧之间的Fantana间隙,被海绵状组织所吸收;③房水经葡萄膜巩膜途径,自脉络膜上腔、睫状体、前巩膜、后巩膜、脉络膜吸收。这是该手术降低眼压的主要机制。OBJECTIVE To further investigate the outflow pathway of Pars Plana Filtration Technique（PPFT）,which proved experimentally and clinically effective for glaucoma surgery especially for intractable glaucoma,and to discuss its mechanism for reducing intraocular pressure.METHODS The experimental and normal rabbits injected carbomer through anterior chamber were operated by the PPFT and no operated rabbits were taken into the experiment.The fluorescing isothiocyanate-bovine serum albumin（FITC-BSA）was injected through anterior chamber into 3 group rabbits＇eyes and then observed the degrees of fluorescent intensity.RESULTS Two hours after FITC-BSA injection,group A and B＇s front conjunctiva and aqueous fluid pool fluorescent intensities showed significantly stronger,but group C showed nothing.Six hours after FITC-BSA injection,group A and B＇s front conjunctiva and aqueous fluid pool fluorescent intensities still showed significantly,the other tissue fluorescent intensities showed weaken,group C＇s ciliary body and epichoroidal space fluorescent intensities showed significantly.Group A and B＇s front conjunctiva and ciliary body,group A＇s posterior sclera,group C＇s ciliary body,epichoroidal space and anterior sclera fluorescent intensities showed weakening,tissue（of other part） of the three groups showed no appearance of fluorescence.CONCLUSIONS There are three outflow pathways of PPFT：（1）Aqueous humor flowed out from sclera incision to infra-conjunctiva and was absorbed by conjunctiva vessel.（2）Aqueous humor flowed out through anterior chamber angle to Fantana gap and was absorbed by cavernous tissue.（3）Uveal-scleral pathway,the aqueous humor flowed out from epichoroidal cavity,ciliary body,anterior sclera and posterior sclera to choroid and was absorbed.The PPFT has three pathways on reduction of IOP.

关 键 词：睫状体平坦部滤过术 青光眼 引流途径 

分 类 号：R775.9[医药卫生—眼科]