[An experimental trial of glaucoma filtering surgery with amniotic membrane].
OBJECTIVE
To investigate the anti-fibroplastic effect of the preserved human amniotic membrane by transplanting on animals in glaucomatous surgery.


METHODS
Trabeculectomy were performed on 48 eyes of 24 rabbits which were divided into 3 groups: group A was treated with the amniotic transplantation under sclerotic flap, group B was performed trabeculectomy using MMC (0.25mg/ml) under sclerotic flap and group C played the role of control which had surgery only. postoperative examinations including the intraocular pressure (IOP) , filtering bleb, reaction of the anterior chamber and complications were performed on 1, 2, 3, 7, 14, 28, 60 days after surgery respectively. A rabbit selected randomly in the three groups was killed in 1, 2, 3, 4, 8 week after operation and extirpated the eyeball to observe the time of decomposition of the amniotic membrane in pathologic tissue slice, counted the number of fibroblast and inflammatory cells with computer and compare their difference.


RESULTS
There were not significant difference of IOP among the three groups except observed on the first day after operations (P > 0.05); Comparing with group B and group C, the complications of group A ( amniotic membrane) didn't increased. The duration of the existing time of the filtering blebs was about 1 month. The decomposed time of the amniotic membrane was about 3-4 weeks, after 4 weeks it was substituted by fibroblast and inflammatory cells. The number of fibroblast counted by computer showed significant difference between group A (0.0205+/-0.01235) and group C (0.0673+/-0.03830) (P=0.017 < 0.05), and no obvious difference with group B. The inflammatory cells of group A (0.4402+/-0.1708) increased greatly in comparison with group B (0.0407+/-0213) and group C (0.0294+/-08876); (t=5.67, P=0.002 < 0.05, t=4.81, P=0.004 < 0.05 respectively).


CONCLUSIONS
The decomposed time of the amniotic membrane is about 3-4 weeks in trabeculectomy. Amniotic membrane has a restraint effect on fibroblast and it can enhance the effect of surgery to lower the IOP in trabeculectomy as well as has less complication. The inflammation reaction in the operation area of the group A is heavier than the others which may be caused by repellent reaction between different species.
Wang
Lan
L
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
Liu
Xing
X
Zhang
Ping
P
Lin
Jianxian
J
D000650:Amnion / Q000637:transplantation*; D000818:Animals; D000963:Antimetabolites / Q000008:administration & dosage; D005347:Fibroblasts; D005901:Glaucoma / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D016685:Mitomycin / Q000008:administration & dosage; D011817:Rabbits; D011897:Random Allocation; D014130:Trabeculectomy / Q000379:methods*
D000963:Antimetabolites; D016685:Mitomycin