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OBJECTIVE: To investigate the effect of trabeculectomy combined with amniotic membrane and extracellular matrix (ECM) of conjunctiva on filtering bleb in rabbits. METHODS: Glaucoma was induced by injecting alpha-chymotrypsin into the posterior chamber of rabbit eyes. 27 rabbits were randomly divided into the following three groups: group (1) trabeculectomy alone as control; group (2) trabeculectomy combined with amniotic membrane transplantation; group (3) trabeculectomy combined with extracellular matrix (ECM) transplantation. IOPs were measured by a Schiƶtz tonometer and filtering bleb observed under a microscopy and electric microscopy at day 1, 7, 14, 21, 28, 35, 42, 56 after surgery. RESULTS: Compared with pre-operation, the IOP in the control group (group 1) was reduced from (34.59 ± 4.44) mmHg (1 mmHg = 0.133 kPa) to (11.31 ± 2.76) mmHg, (19.20 ± 5.27) mmHg, (21.17 ± 4.36) mmHg, (22.22 ± 1.39) mmHg, (23.90 ± 1.97) mmHg, (23.67 ± 1.73) mmHg, respectively, after surgery. In the group 2, the IOP was decreased from (34.38 ± 4.21) mmHg to (10.48 ± 2.45) mmHg, (12.80 ± 3.41) mmHg, (13.50 ± 2.25) mmHg, (16.17 ± 1.73) mmHg, (17.22 ± 1.32) mmHg, (16.71 ± 1.52) mmHg, respectively. In the group 3, the IOP was decreased from (34.66 ± 4.49) mmHg to (10.94 ± 2.75) mmHg, (11.29 ± 2.40) mmHg, (13.93 ± 3.55) mmHg, (15.63 ± 3.54) mmHg, (15.70 ± 2.44) mmHg, (15.12 ± 3.65) mmHg, respectively, at day 1, 7, 14, 28, 42, 56, post-operatively. IOPs in the group 2 and 3 were significantly (P < 0.01) lower than that in the control group (group 1) at post-operative day 7, 14, 28, 42, 56. However, there was no IOP difference between the group 2 and 3 post-operatively at any time. Morphologically, the filtering blebs were flatted at day 28 in the group 1, while were normal in the group 2 and 3 at day 56. Less scar formation of filtering blebs was observed in group 2 and 3 compared with group 1. CONCLUSIONS: Trabeculectomy combined with the application of amniotic membrane or conjunctiva ECM can improve filtering bleb function and reduce scar formation that lead to a better IOP control after surgery. La: Chinese
Dr. J. Wang, Department of Ophthalmology, Ji Shui Tan Hospital, Peking University, Beijing 100035, China. wangjing1956@163.com
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
5.3 Other (Part of: 5 Experimental glaucoma; animal models)