目的:研究He-Ne激光对兔眼小梁切除术后滤过道瘢痕化的影响及其机制,探讨He-Ne激光在青光眼小梁切除术中的应用价值。方法:于小梁切除手术前采用功率密度200mW/cm2He-Ne激光照射兔眼(右眼)手术区,照射部位选择鼻上象限角膜缘紧邻上直肌处,光斑直径4mm,照射时间10min,1次/d,连续照射3d。最后一次照射后24h实施双眼小梁切除术。手术后第7,14,28d检测手术区组织结缔组织生长因子(connective tissue growth factor,CTGF);第14和第28d检测胶原密度(masson染色)。左眼设为单纯手术对照组。每时间点各7只兔。结果:手术后第7,14d,He-Ne激光组CTGF表达较对照组减少(P=0.01;P=0.005)。手术后第14,28dHe-Ne激光组胶原密度显著低于对照组(P=0.013;P=0.01)。结论:功率密度200mW/cm2He-Ne激光预照射小梁切除术手术区域,可下调术后该区域成纤维细胞CTGF表达并减少胶原合成,可能有助于减少兔眼小梁切除术后滤过道瘢痕形成。He-Ne激光有可能为预防青光眼滤过手术后瘢痕化提供新的方法。

AIM:To investigate the influence of He-Ne laser on connective tissue growth factor (CTGF) expression and collagen formation of fibroblast in filtration site after trabeculectomy in rabbit,and to discuss the mechanism for preventing scar formation with He-Ne laser in vivo. ·METHODS:The upper nasal limbus area next to the upper rectus muscle in right eyes received 10 minutes He-Ne laser irradiation (200mW/cm2) every day for three days,the left eyes served as control. Twenty-four hours after the last irradiation,both eyes of the rabbits were took trabeculectomy surgery. The expressions of CTGF in the filtration area were tested on the 7th,14th and 28th day after surgery and collagen density was tested on the 14th and 28th day after surgery. Each of the time point had 7 rabbits. ·RESULTS:The expression of CTGF was lower than that of the control group’s on the 7th and 14th day after trabeculectomy surgery (P=0.01,P=0.005). When examined on the 14th and 28th day,the collagen density of irradiation group were significantly lower than that of the control group’s (P=0.013,P=0.01). ·CONCLUSION:Pretreating the filtration area with 200mW/cm2 He-Ne laser may be helpful in preventing scar formation after trabeculectomy in rabbit,possibly due to downregulation of the expression of CTGF and collagen synthesis in fibroblasts. He-Ne laser may be developed into a new scar preventing method in filtration surgery.

R779.6

中国湖北省武汉市，华中科技大学同济医学院附属同济医院2008年新技术新业务基金资助项目（No.2008006）；中国湖北省武汉市科技攻关课题 （No.200852199600）