国际眼科纵览

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交联透明质酸钠在青光眼手术中的应用

田琨  钟华   

  1. 650032 昆明医科大学第一附属医院眼科
  • 收稿日期:2017-05-18 出版日期:2017-08-22 发布日期:2017-09-01
  • 通讯作者: 钟华,Email:zhoculist@163.com E-mail:zhoculist@163.com

Application of cross-linked or reticulated hyaluronate in glaucoma surgery

TIAN Kun, ZHONG Hua   

  1. Department of Ophthalmology, First Affliated Hospital of Kunming Medical University, Kunming 650032, China
  • Received:2017-05-18 Online:2017-08-22 Published:2017-09-01
  • Contact: ZHONG Hua, Email: zhoculist@163.com E-mail:zhoculist@163.com

摘要:

青光眼手术失败的主要原因是由于瘢痕组织形成导致滤过泡发生纤维化。尽管抗纤维化药物如丝裂霉素C和5-氟尿嘧啶可明显改善手术成功率,其潜在术后并发症问题难以令人满意。近年来,开发的一些新的药物、材料或手段,尤其是交联透明质酸钠尤为引人瞩目。交联透明质酸钠减少瘢痕形成的作用机制,在于其物理屏障效应和本身所具有的抗炎特性的直接或间接作用;交联性状可使其降解时间延长。临床初步研究显示,交联透明质酸钠在青光眼手术中的应用对控制眼压和减少术后瘢痕化均具有较好效果。

Abstract:

Scar tissue deposition, which results in fibrosis of the formatted functional structures such as bleb, is the most frequent cause of glaucoma operation’s failure. Although antifibrotic agents such as mitomycin C and 5-fluorouracil have significantly improved the efficacy of the operation, concerns remain regarding the potential increases in postoperative complications. Various novel or newer pharmacological substances have been developed in recent years with different ways to modulate the wound healing after the surgery, of which cross-linked or reticulated hyaluronate appears particular attractive. It is suggested that the mechanisms of scare formation-minimizing effect of cross-linked or reticulated hyaluronate are largely attributed to its space-occupying and inherent anti-inflammatory properties directly and indirectly, and the cross-linked format confers it with a slower degrading time. The preliminary results of its clinical application in glaucoma surgery are promising in term of both controlling intraocular pressure and decreasing postoperative complications.