[Effects of trabeculectomy combined with amniotic membrane and extracellular matrix of conjunctiva on filtering bleb in rabbits eyes].
OBJECTIVE
To investigate the effect of trabeculectomy combined with amniotic membrane and extracellular matrix (ECM) of conjunctiva on filtering bleb in rabbits.


METHODS
Glaucoma was induced by injecting alpha-chymotrypsin into the posterior chamber of rabbit eyes. 27 rabbits were randomly divided into the following three groups: group (1) trabeculectomy alone as control; group (2) trabeculectomy combined with amniotic membrane transplantation; group (3) trabeculectomy combined with extracellular matrix (ECM) transplantation. IOPs were measured by a Schiötz tonometer and filtering bleb observed under a microscopy and electric microscopy at day 1, 7, 14, 21, 28, 35, 42, 56 after surgery.


RESULTS
Compared with pre-operation, the IOP in the control group (group 1) was reduced from (34.59 +/- 4.44) mm Hg (1 mm Hg = 0.133 kPa) to (11.31 +/- 2.76) mm Hg, (19.20 +/- 5.27) mm Hg, (21.17 +/- 4.36) mm Hg, (22.22 +/- 1.39) mm Hg, (23.90 +/- 1.97) mm Hg, (23.67 +/- 1.73) mm Hg, respectively, after surgery. In the group 2, the IOP was decreased from (34.38 +/- 4.21) mm Hg to (10.48 +/- 2.45) mm Hg, (12.80 +/- 3.41) mm Hg, (13.50 +/- 2.25) mm Hg, (16.17 +/- 1.73) mm Hg, (17.22 +/- 1.32) mm Hg, (16.71 +/- 1.52) mm Hg, respectively. In the group 3, the IOP was decreased from (34.66 +/- 4.49) mm Hg to (10.94 +/- 2.75) mm Hg, (11.29 +/- 2.40) mm Hg, (13.93 +/- 3.55) mm Hg, (15.63 +/- 3.54) mm Hg, (15.70 +/- 2.44) mm Hg, (15.12 +/- 3.65) mm Hg, respectively, at day 1, 7, 14, 28, 42, 56, post-operatively. IOPs in the group 2 and 3 were significantly (P < 0.01) lower than that in the control group (group 1) at post-operative day 7, 14, 28, 42, 56. However, there was no IOP difference between the group 2 and 3 post-operatively at any time. Morphologically, the filtering blebs were flatded at day 28 in the group 1, while were normal in the group 2 and 3 at day 56. Less scar formation of filtering blebs was observed in group 2 and 3 compared with group 1.


CONCLUSIONS
Trabeculectomy combined with the application of amniotic membrane or conjunctiva ECM can improve filtering bleb function and reduce scar formation that lead to a better IOP control after surgery.
Wang
Jing
J
Department of Ophthalmology, Ji Shui Tan Hospital, Peking University, Beijing 100035, China. wangjing1956@163.com
Tang
Shao-hua
SH
Yu
Zheng-yu
ZY
D000650:Amnion / Q000637:transplantation*; D000818:Animals; D003228:Conjunctiva / Q000473:pathology / Q000601:surgery; D004195:Disease Models, Animal; D005109:Extracellular Matrix; D005901:Glaucoma / Q000601:surgery; D011184:Postoperative Period; D011817:Rabbits; D014130:Trabeculectomy