聚羟基脂肪酸和聚乳酸膜在兔青光眼滤过手术和角膜层间移植手术中的探索应用
作者:
作者单位:

(1. 北京大学第三医院眼科,眼部神经损伤的重建保护与康复北京市重点实验室,北京 100191; 2. 北京大学人口研究所,北京 100871; 3. 温州医科大学附属眼视光医院,浙江温州 325027; 4. 清华大学化工系高分子研究所,北京 100084; 5. 北京市射线应用研究中心,北京 100012; 6. 北京科技大学,北京 100083)

中图分类号:

R-33

基金项目:

国家自然科学基金(编号:30772376)


Exploration and application of polyhydroxyalkanoates and polylactic acid membranes during glaucoma filtering surgery and interlaminar transplantation in rabbits
Author:
Affiliation:

(1. Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China. 2. Institute of Population Research, Peking University, Beijing 100871. 3. Eye Hospital Affiliated to Wenzhou Medical University, Wenzhou 325027. 4. Institute of Polymer Science and Engineering, Tsinghua University, Beijing 100084. 5. Beijing Ray Applied Research Center, Beijing 100012. 6. University of Science and Technology Beijing, Beijing 100083)

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    摘要:

    目的 评价膜性聚羟基脂肪酸(polyhydroxyalkanoates,PHA)和聚乳酸(polylactic acid,PLA)在兔青光眼滤过手术(glaucoma filtration surgery,GFS)中的应用维持眼压(intraocular pressure,IOP)的效果,评价膜性聚羟基脂肪酸在角膜层间植入后的形态学?方法 选新西兰兔28 只,其中24 只随机分为6 组,GFS 中植入高分子材料者为实验组,实验组按植入材料辐照剂量不同又分为4 个亚组:PHA-low 组?PHA-high 组?PLA-low 组和PLA-high组,对应的膜性材料植入巩膜瓣和结膜瓣下;GFS 中联合使用丝裂霉素(mitomycin C,MMC),使用者设为阳性对照MMC 组:巩膜瓣和结膜瓣下使用MMC(0.2 mg/ m)3 min;单纯行兔GFS 而不用任何材料者设为空白对照组?三组分别于术前和术后1?3?7?14?28?84 d 分别测量术眼眼压?4 只角膜层间植入PHA 膜,观察术后84 d 角膜形态学变化?结果 术后84 d,PHA-low 和PLA-high 组眼压比空白对照组眼压低( P < 0.05),PHA-low 和PLA-high 实验组眼压与MMC 组眼压近似( P > 0.05)?形态学见滤过通道未被胶原纤维充填,植入材料周围胶原纤维大致平行排列?角膜层间植入PHA 膜的周边胶原结构未发生明显变化?结论 膜性PHA 和PLA 应用于兔GFS 可能促进眼压维持,效果与MMC 类似?其作用机制可能是通过机械性阻隔纤维组织长入滤过通道实现的?

    Abstract:

    Objective To evaluate the effect of two polymer membranes, polyhydroxyalkanoates (PHA) and polylactic acid (PLA) during glaucoma filtration surgery (GFS), and to evaluate the morphology of membranous PHA after interlamellar implantation. Methods Twenty-eight New Zealand white rabbits were chosen and twenty-four of them were randomly divided into 6 groups (n =4): the PHA-low group, PHA-high group, PLA-low group, PLA-high group, positive control group (MMC group) and blank control group. The rabbits in each group received GFS. The corresponding polymer membranes were implanted under the scleral flap, while the MMC group was treated with 0.2 mg/ mL mitomycin C (MMC) for 3 minutes, and the blank control group was treated without extra drugs. The intraocular pressure (IOP) was examined at 0 d, 1 d, 3 d, 7 d, 14 d, 28 d and 84 d after GFS. The corneal layers of four rabbits were implanted with PHA membranes and the corneal morphological changes were observed after 84 d. Results The IOP of the PHA-low and PLA-high groups was lower than that of the blank control group at 84 d after GFS ( P < 0.05), and was similar with that of the MMC group ( P > 0.05). Morphological studies showed that there were no collagenous fibers filling in the duct, and the collagenous fibers around the membranes were generally arranged in parallel. There were no obvious changes in the peripheral collagen structure after implantation of PHA membranes between the corneal layers. Conclusions Application of PHA and PLA membranes during GFS in rabbits may maintain the level of IOP, and the effect is similar with MMC. The mechanism may be achieved through the mechanical blocking of fibrous tissue.

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周吉超,戴婉薇,张绍丹,郭宝华,曾心苗,张雅斓,张纯.聚羟基脂肪酸和聚乳酸膜在兔青光眼滤过手术和角膜层间移植手术中的探索应用[J].中国比较医学杂志,2018,28(3):36~42.

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  • 收稿日期:2018-01-31
  • 在线发布日期: 2018-04-11
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