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引用:Uzeyir Gunenc,Gul Arikan,Ferim Gunenc,Banu Lebe,Sitki Eren,Elvan Ocmen,Arif Taylan Ozturk.新型经脉络膜上腔引流房水植入装置Suprajet的疗效观察.国际眼科杂志 2017;17(10):1807-1811,doi:10.3980/j.issn.1672-5123.2017.10.02
新型经脉络膜上腔引流房水植入装置Suprajet的疗效观察
Suprachoroidal drainage of aqueous humour with a novel implant: Suprajet
投稿时间:2016-05-20  修订日期:2017-07-31
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DOI:10.3980/j.issn.1672-5123.2017.10.02
关键词:  青光眼  引流器  脉络膜上腔
Key Words:  glaucoma  shunt  suprachoroidal surgery
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作者单位
Uzeyir Gunenc 35340 土耳其,伊兹密尔,度库兹埃路尔大学医学院眼科
Gul Arikan 35340 土耳其,伊兹密尔,度库兹埃路尔大学医学院眼科
Ferim Gunenc 35340 土耳其,伊兹密尔,度库兹埃路尔大学医学院麻醉和重症监护科
Banu Lebe 35340 土耳其,伊兹密尔,度库兹埃路尔大学医学院病理科
Sitki Eren 35340 土耳其,伊兹密尔,度库兹埃路尔大学医学院眼科
Elvan Ocmen 35340 土耳其,伊兹密尔,度库兹埃路尔大学医学院麻醉和重症监护科
Arif Taylan Ozturk 35340 土耳其,伊兹密尔,度库兹埃路尔大学医学院眼科
                    
AuthorInstitution
Uzeyir Gunenc Department of Ophthalmology, School of Medicine, Dokuz Eylul University, Izmir 35340, Turkey
Gul Arikan Department of Ophthalmology, School of Medicine, Dokuz Eylul University, Izmir 35340, Turkey
Ferim Gunenc Department of Anesthesiology and Intensive Care, School of Medicine, Dokuz Eylul University, Izmir 35340, Turkey
Banu Lebe Department of Pathology, School of Medicine, Dokuz Eylul University, Izmir 35340, Turkey
Sitki Eren Department of Ophthalmology, School of Medicine, Dokuz Eylul University, Izmir 35340, Turkey
Elvan Ocmen Department of Anesthesiology and Intensive Care, School of Medicine, Dokuz Eylul University, Izmir 35340, Turkey
Arif Taylan Ozturk Department of Ophthalmology, School of Medicine, Dokuz Eylul University, Izmir 35340, Turkey
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摘要:
      

目的:评估一种由睫状体前和脉络膜上腔引流房水的新型植入装置Suprajet的有效性和安全性。

     方法:该项研究使用5只兔子。每只兔子的一眼植入Suprajet。引流器通过位于上方的透明角膜切口,经由前房置入脉络膜上腔。引流器近端位于睫状体根部,远端位于脉络膜上腔。兔子饲养、观察4wk。使用Tonopen AVIA测量术前和术后的眼压。最后一次随访观察时,兔子被牺牲处死,眼球摘除,进行大体上和组织学的观察评估。

     结果:术前眼压为18.6±6.1mmHg。术后1wk眼压为8.4±1.1mmHg。术后2wk 1只兔子死亡。因此,仅有4只兔子进行了后续观察。术后2wk眼压为11.0±2.8mmHg,术后3wk为9.50±3.1mmHg,术后4wk为11.3±3.3mmHg。与术前平均眼压相比,仅第1周的平均眼压显著降低(P=0.042),术后2wk、3wk和术后4wk的平均眼压无明显变化(P=0.66, P=0.66, P=0.102)。术中并发症包括3眼少量出血。术后2d出血已经完全吸收。对摘除眼球的大体观察发现,1眼中引流器的远端位于玻璃体内,而不是位于脉络膜上腔; 其它3眼引流器的远端位于脉络膜上腔。所有眼中,近端都位于前房角。对摘除眼的组织学检查发现:不规则的胶原蛋白束和纤维沉积,包括引流器周围大量的成纤维细胞和组织细胞。

     结论:这一项初始动物研究显示,青光眼中Suprajet植入是一项有前景的术式。需要进行更进一步的研究以评估其有效性和安全性。

Abstract:
      AIM: To evaluate the efficacy and safety of a new implant, Suprajet(VSY Biotechnology, Istanbul, Turkey), which is developed for supraciliary and suprachoroidal drainage of aqueous humour.

     METHODS: Five rabbits were included in the study. One Suprajet shunt was implanted in one eye of each rabbit. Implantation was performed by a superior clear corneal incision through the anterior chamber into the suprachoroidal space. Proximal end of the implant was placed in the iris root resting against the scleral spur, distal end was placed in the suprachoroidal space. Rabbits were followed for 4wk. Preoperative and postoperative intraocular pressure(IOP)levels were measured with Tonopen AVIA. At last follow-up visit animals were sacrificed and eyes were enucleated. Macroscopic and histopathologic evaluation of the eyes were made.

     RESULTS: Mean preoperative IOP was 18.6±6.1 mmHg. Mean postoperative IOP was 8.4±1.1 mmHg, at one week. At the 2nd week of the follow-up period one rabbit died. Thereafter, only 4 rabbits were followed. Mean postoperative IOP was 11.0±2.8 mmHg at the 2nd week, 9.50±3.1 mmHg at the 3rd week and 11.3 ±3.3 mmHg at 4th week after the operation. When mean preoperative IOP was compared with the postoperative IOP values, only the IOP at the first week was found as significantly lower(P=0.042). There was no statistically significant difference between mean preoperative IOP level and mean IOP level at 2, 3 and 4wk postoperatively(P=0.66, P=0.66 and P=0.102, respectively). As an intraoperative complication, minimal hyphema was noted in three eyes during the surgery. However, the next day hyphema cleared completely. Macroscopic evaluation of the enucleated material showed that in one eye the distal end of the implant was in the vitreous instead of suprachoroidal space, in the other 3 eyes the distal end of the implant was noted in the suprachoroidal space. In all eyes, proximal end of the implant was localized in the anterior chamber angle. Histopathologic evaluation of the enucleated eyes showed deposition of irregular collagen bundles and fibroplasia including numerous fibroblastic and histiocytic cells around the implant.

     CONCLUSION: This preliminary animal study showed that implantation of Suprajet in glaucoma is a promising procedure. Further studies are needed to evaluate its efficacy and safety profile.

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