| Objective:To study a new surgical method, we implanted M-shaped frame under the scleral flap, and open a window at Pars plana to increase aqueous outflow, named "Filering Pathway Plasty and Supraciliary Spaces Opening Surgery". The purpose of the study is to verify the feasibility, safety and efficacy of PMMA scleral flap frame under the scleral flap, and verify the feasibility of the uveal scleral aqueous drainage.Methods:Twenty-five rabbits were selected. Filering pathway plasty and supraciliary spaces opening surgery group was the experimental group and the trabeculectomy group was the control group. After 2 months of systematic observation, we obtained IOP, anterior chamber, bleb morphology, UBM, radiology, pathology and immunohistochemistry data in different periods.Results:1. Did not find any negative effects and adverse reactions.2. There were significant difference between the IOP values of 1 week,1 month and 2 months after surgery of the experimental groups and the preoperative IOP (P<0.05). There were significant differences between the IOP value of 1 week and 1 month after surgery of the control group and the preoperative IOP (P<0.05), but there was no significant difference between the IOP values of 2 month after surgery of the control groups and the preoperative IOP (P> 0.05).3. One day after surgery, the anterior chambers of the experimental group and control group were shallowing.2 days after surgery,8 cases of the experimental group returned to preoperative levels of 4CT and 11 cases of the control group returned to preoperative levels of 4CT.3 days after surgery,17 cases of the experimental group returned to preoperative levels of 4CT and 16 cases of the control group returned to preoperative levels of 4CT.1 week after surgery,23 cases of the experimental group returned to preoperative levels of 4CT and 24 cases of the control group returned to preoperative levels of 4CT.4. One week after surgery, the proportions of functional filtering bleb were 100%of the experimental group and control group.2 weeks after surgery, the proportion of functional filtering bleb was 90%of the experimental group and it was 35%of the control group.1 month after surgery, the proportion of functional filtering blebs was 33.3%of the experimental group and it was 6.7%of the control group.2 month after surgery, the proportion of functional filtering blebs was 40%of the experimental group and it was 0%of the control group.5. One week after surgery, UBM examination showed M-shaped frame hyperechoic, aqueous filtration gap, and black low-echo areas in the experimental group, and showed the water filtration gap and black low-echo area in the control group.2 weeks after surgery, UBM showed frame hyperechoic and aqueous filtration area in the experimental group and showed water filtration channel narrowed and black low echo area in the control group.1 month after surgery, UBM showed water filtration channel and black low-echo areas in the experimental group and showed no water filtration gap and the scleral flap adhesion in the control group.6. One month after surgery, radiation r count test results showed there was significant difference between that the experimental group and control group.7. One week after surgery, pathology results showed tissue edema, little new blood vessels. Fibroblast proliferation and inflammatory cell infiltration were seen. Intrascleral hemorrhage and edema can be seen at the operating area in control group, and a small amount of new blood vessels, more fibroblasts and inflammatory cells.2 weeks after surgery, inflammatory cells decreased, fibroblast cells gradually shift to the fiber cells, Neovascularization increased in the experimental group. Angiogenesis increased, fibroblast cells increased gradually to the fiber cell transformation, surgical areas of inflammatory cells decreased in the control group.1 month after surgery, fibroblast cells gradually transformed into fiber cells, gradually fibrosis, showing that a small amount of collagen in experimental group. In control group, significant areas of tissue fibrosis, fibrous tissue is gradually repaired.2 months after surgery, collagen cells and collagen increased in experimental group and collagen increased fibrosis in control group. 8. Immunohistochemistry showed that there were no significant differences of the PCNA-positive cell counts between the experimental group and the control group 1 week,2 weeks,1 month and 2 months after surgery (P> 0.05).Conclusions:1. Filering Pathway Plasty and Supraciliary Spaces Opening Surgery is safe and easy to operate.2. The fibroblast proliferation and scar formation process is similar in experimental group and control group. There is no excessive tissue reaction in the experimental group.3. IOPs of two groups are decreased, and IOP of experimental group is much significant decreased.4. Scleral flap frame might lengthen the filtration foam molding time and extend the aqueous drainage.5. The higher r counts in experimental group means the uveal scleral drainage of aqueous humor is the main drainage channel of the experimental group.
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