| Objective:When medical and laser therapy fail to control intraocular pressure,glaucoma filtration surgery needs to be performed.Although the standard of medical and laser therapy have improved greatly,the failing rate of glaucoma filtration surgery is higher yet.The principal cause of failure is wound healing caused by fibroblast proliferation and scar formation in fitration space.Agents that interfere with wound healing improve the success rate of glaucoma filtration surgery both in experimental animals and in patients.However,they are associated with adverse side effects,some of which have serious toxicity and suffer certain restriction in clinical application.So we need to explore a kind of drugs of inhibiting scar formation in glaucoma filtration surgery.lt should have high effect and little toxicity.PacIitaxel is a kind of anti-microtubule drug,which halts cellular mitosis ^ interferes cellular moving^ trending and intracellular transforming.The agent was used in the treatment of ovarian cancer at first,then breasU lung cancer and so on.But it was reported less in the ophthalmologic research.Paclitaxel was used during surgery and following surgery in the research.We observed its effect of decreasing the intraocular pressure. percentage of the functional blebs. antiproliferativerole of the fibroblasU collagenic kinds and configuration in the course of wound healing.Our object is to evaluate the effects of paclitaxel on inhibiting scar formation in the glaucoma filtration surgery.Methods: 1 .Animals Thirty New Zealand white rabbits were randomly divided into three groups:contro experiment I experiment II group.Each group has ten rabbits.We operated on every rabbit eye according to standard of trabaculactomy and placed a piece of cotton with 0.2mg/ml MMC for 5 minutes in control group 0.3mg/ml paclitaxel for 5 minutes in experiment group I 0.3mg/ml paclitaxel for 5 minutes in experiment group II .In experiment group II we injected paclitaxel subconjunctiva on days 3 6 and 9 following surgery.2.1ntraocular pressure measurement.Intraocular pressure(IOP) measurements were performed before surgery and on postoperative days 4 60 respectively.We compared the difference among the three groups on different stages.3.Electroretinogram(ERG):ERG was examined before operation and postoperative days ecorded a-wave and b-wave amplitude of retinal rod cell reaction and the rod-cone cell mixture reaction.We compared the difference of a-wave and b-wave amplitude among preoperation > postoperative days 4^ 7> 14 and 28 in every group.At the same time we recorded the amplitude of 30Hz flicker reaction and compared them among preoperation > postoperative days 4 > 7>14 and 28 in every group.4.Slit-lamp microscope examination We observed the rabbits'filtration blebs, corneal epithelium and conjunctival wound on postoperative days 4,7, 14, 28, 60 and compared the percentage of injured comeal epithelium, the functional blebs and conjunctival wound leak.S.Histopathology Two rabbits were killed on postoperative days 4, 7, 14, 28, 60 every group.We kept their filtration blebs, enucleated their eyes, fixed them, made paraffin slices. We observed the filtration passage by performing H-E staining.We observed the expression of proliferative cell nuclear antigen(PCNA) in the filtration area and counted the number of positive cell nuclear under microscope after performing immunohistochemical staining.We observed collagen formation under polarizing microscope by 2.4.6-Trinitrophend-Sirius Red F3B staining.Results:! The change of the intraocular pressure:There was no significant difference among three groups before operation and postoperative days 4 (/*>0.05).There was also no significant difference between experiment group I and control group postoperative days 7, 14, 28 and 60.But the difference was significant between experiment group II and control group on 7, 14, 28, 60days after surgery(P<0.05).2 The comparison of filtration blebs: There was no difference on the percentage of the functional...
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