目的:研究小梁切除术中辅助应用C3F8气体后滤过道的病理组织学变化,探讨C3F8改善滤过泡的性状和功能、提高手术成功率的作用机理.方法:将新西兰兔进行小梁切除术随机分为单纯小梁切除术组、小梁切除术组联合C3F8气体组、小梁切除术组联合MMC组;并应用病理组织学和免疫组化技术,对兔眼术后3d,1,2,4wk 5个不同时期的滤过泡组织进行病理检查,观察成纤维细胞、新生胶原纤维、新生血管、炎症细胞的改变.结果:C3F8气体组和单纯小梁切除术组术后滤过道新生胶原纤维量、成纤维细胞差异均有统计学意义;MMC组和单纯小梁切除术组术后滤过道新生胶原纤维量、成纤维细胞差异均有统计学意义;C3F8气体和MMC组术后差异无统计学意义.三种不同手术方式术后滤过道的新生血管生长情况和术后5个不同时期的滤过道的炎症细胞进行比较差异都无统计学意义.结论:小梁切除术中应用C3F8气体可在术后早期抑制成纤维细胞增殖和新生胶原纤维的合成,抑制或减轻术后滤过道的疤痕化,提高手术成功率.%AIM: To study the histopathologic changes of filtering blebs by subconjunctival retention of perfiuropropane (C3F8) after trabeculectomy in rabbit eyes.METHODS: The inflammatory change, fibroblasts,newborn collagen, neovascularization of filtering blebs after surgery were observed by histopathological and immunohistochemical techniques.RESULTS: The number of fibroblasts in either the trabeculectomy plus C3F8 group or the trabeculectomy plus MMC group was significantly lower than that in the trabeculectomy group. There was no significant difference in the number of fibroblasts between the two groups.The number of the newborn collagen in either the trabeculectomy plus C3F8 group or the trabeculectomy plus MMC group was significantly lower than that in the trabeculectomy group. However, there was no significant difference in the number of newborn collagen fibers between the two groups. Neovascularizations and infiammation of filtering blebs: the differences were not significant among the trabeculectomy plus C3F8 group, the trabeculectomy plus MMC group and the trabeculectomy group.CONCLUSION: Trabeculectomy with subconjunctivalretention C3F8 gas can enhance the success rate of surgery by suppressing the growth of fibroblasts and synthesis of newborn collagen fiber, inhibiting or reducing scar formation.
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