| Objective: This study was designed to evaluate the effectiveness of anterior lens capsule inclusion in combined trabeculectomy and cataract surgery in preventing scar formation of the filtering bleb and controlling intraocular pressure in rabbit model.Methods: 24 eyes (12 rabbits) with glaucoma model were studied,anterior lens capsule inclusion in trabeculectomy with the small-incision cataract surgery were performed on all right eyes(experimental group) and no implants were applicated in trabeculectomy with the small-incision cataract surgery on all left eyes(control group).These operated eyes were followed up from day 1 to 6 months postoperatively. then intraocular pressure(IOP) was measured and filtering blebs were observed after surgery.Other Main Outcome measures: cornea,conjunctiva,formation of the anterior chamber, anterior chamber depth,Inflammatory reaction,achievement ratio of operation and complications were analyzed.On week 1,2,4,8,12 and 24 after surgery the animal were killed in batch. Tissue was harvested from the bleb area and was made pathological section. HE staining,1ight microscope and microphoto analysis technique were applied to observe the cytological and histopathologic characteristics of the filtering tunnels.Results: There was no significant difference between the two groups on cornea,conjunctiva condition,formation of the anterior chamber, anterior chamber depth,Inflammatory reaction,IOP (1,2 weeks)and complications.There was significant difference between the two groups on IOP (4,8,12,24weeks),acumulation survival rate of function filtration bleb.There are small amounts inflammatory cell (neutrophilic granulocyte) and fibroblast cell in operating field 1 wk after operation and at 12wk the anterior lens capsule tissues absorption partly with only a little foreign body giants left in the filtering tunnels in Experimental Group.All the cells in the filtrating tunnel disappeared 6 month after surgery. The fibroblast proliferation in Control Group occurred at lwk and the filtrating tunnel closed with angiogenesis at 1 month after surgery.Fibroblast proliferation among 1wk,4wk and 24wk after surgery with no statistical change during the whole time course in Experimental Group (t=1.218, 1.349,1.196, respectively,P>0.05). Significant statistica1 differences were observed by comparing the fibroblasts numbers per unit area in the filtrating tunnel at 1wk,2wk,4wk after surgery in Experimental Group and those in Control Group (t=2.795,2.652,2.391,respectively, P<0.05).Conclusion: Anterior lens capsule was totally absorbed at 6 months postopera tively.Anterior lens capsule inclusion in trabeculectomy with cataract surgery can possibly control intraocular pressure effectively, long-term sustainability of functional filtration bleb , inhibition of the proliferation of fibroblasts and opening of the filtrating pathway in the experimental animal models were satisfied.Compared to the control group, anterior lens capsule application has less complication. |
PDF Full Text Request