非穿透性小梁切除术房水葡萄膜巩膜途径的实验研究  

Experimental study on uveoscleral pathway after non-penetrating trabecular surgery in rabbit eyes

作　　者：朱子诚[1] 袁华音[1] 孙思勤[1] 张国梅[1] 胡闻[2] 陈柯[2] 

机构地区：[1]安徽医科大学医学二系,合肥安徽省立儿童医院眼科230001 [2]安徽医科大学医学二系病理科

出　　处：《眼科新进展》2003年第6期412-414,共3页Recent Advances in Ophthalmology

摘　　要：目的　探讨非穿透性小梁切除术 (nonpenetratingtrabecularsurgeryNPTS)房水葡萄膜巩膜引流途径的形态学情况 ,进一步阐明其降压机制。方法　 2 0只兔 4 0眼随机分为实验组 (NPTS) ,对照组 (小梁切除 +虹膜根切术 )和正常组 ,术后 1周于正常组前房内注入微量示踪剂异硫氰酸荧光素牛血清白蛋白 (fluoresceinisothiocyanate bovineserumalbumin ,FITC BSA) ,于 2、4、6、8、10h各处死家兔 4只 ,摘除双侧眼球作冰冻切片 ,荧光显微镜下观察并确定睫状体、房水池、脉络膜上腔、前、后巩膜和脉络膜的荧光强度等级。结果　实验组和对照组术前眼压相似 (实验组 2 .19kPa± 0 .37kPa ,对照组 2 .0 0kPa± 0 .34kPa ;P >0 .0 5 ) ,术后 1周时眼压差别没有统计学意义 (实验组 1.5 1kPa± 0 .35kPa ,对照组 1.4 4kPa± 0 .31kPa;P >0 .0 5 )。实验组术后葡萄膜巩膜途径各部位的荧光强度均比正常组和对照组增强 ,而正常组亦强于对照组。结论　NPTS具有和小梁切除术相似的降压效果 ,房水由房水池和 (或 )睫状体间隙到脉络膜上腔后 ,主要经前巩膜排出 ,后巩膜及脉络膜排出较少 ,是其降压的主要机制之一。Objective To discuss the effects of non penetrating trabecular surgery(NPTS) in rabbit eyes on the morphology of the uveoscleral pathway and to explore the mechanism of aqueous humor outflow.Methods Forty eyes of 20 rabbits were randomly divided into experimental(NPTS),control(trabeculectomy) and normal groups.For experimental and control groups,one week postoperatively anterior chambers were infused into microamounts of fluorescein isothiocyanate bovine serum albumin(FITC BSA) as the tracer while did so for normal group .Four rabbits each time were killed at 2,4,6,8,10 hours after infused FITC BSA, their eyeballs were removed and frozen sections were performed. Degrees of fluorescent intensity of ciliary body,aqueous fluid pool, suprachoroidal space, anterior and posterior sclera, choroid were observed under fluorescence microscopy.Results Mean preoperative intraocular pressures(IOP) were similar in both groups(2.19kPa±0.37kPa in the experimental group and 2.00 kPa±0.34kPa in the control group; P >0.05),and there was nostatistically siginificant difference in IOP decrease at one week postoperative (1.51kPa±0.35kPa in the experimental group and 1.44kPa±0.31kPa in the control group; P >0.05).Compared with control and normal groups, fluorescent intensities of all uveoscleral pathway sites were significantly stronger after NPTS. Fluorescent intensities in normal group were also stronger than that of control group.Conclusion Non penetrating trabecular surgery can effectively lower the IOP as well as traditional trabeculectomy. Aqueous humor flows into the suprachoroidal space through the thin scleral bottom(aqueous humor pond) or ciliary body and out through anterior sclera predominantly, smaller amounts of aqueous humor leave the eye through posterior sclera and choroid, which is one of the main causes resulting in the decrease of the IOP in NPTS.

关 键 词：非穿透性小梁切除术 葡萄膜巩膜途径 脉络膜上腔 房水池 

分 类 号：R775[医药卫生—眼科]