综述
ENGLISH ABSTRACT
抑制Ahmed青光眼引流阀植入术后滤过区瘢痕化相关研究进展
江梦璐
董艾萌 [综述]
原慧萍 [综述]
作者及单位信息
·
DOI: 10.3760/cma.j.cn115989-20201130-00807
Research progress on inhibition of filtration area scarring after implantation of Ahmed glaucoma valve
Jiang Menglu
Dong Aimeng
Yuan Huiping
Authors Info & Affiliations
Jiang Menglu
Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
Dong Aimeng
Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
Yuan Huiping
Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
·
DOI: 10.3760/cma.j.cn115989-20201130-00807
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摘要

Ahmed青光眼引流阀(AGV)植入术是治疗难治性青光眼的主要手段之一,其相对于常规滤过性手术具有更高的手术成功率。但AGV作为异物常会引起滤过区瘢痕组织增生,包裹引流盘,从而抑制房水外流,引起眼压重新升高,导致手术失败。尽管AGV植入术中和术后多次注射抗代谢药物可抑制术后滤过区瘢痕化,但术后多次结膜下注射不仅会引起患者的不适,而且会引起相应并发症,因此需要对AGV进行改进,避免反复注射药物,使药物在局部缓慢释放,同时减轻AGV的异物反应。最近,Ologen胶原蛋白、聚2-羟基甲基丙烯酸乙酯凝胶、聚乳酸-羟基乙酸共聚物和天然蛋白页岩等新型材料及技术的应用为抑制AGV植入术后滤过区瘢痕化提供了新的治疗方法选择。本文从AGV引流盘材料的发展、AGV联合新型材料药物缓释系统的构建、AGV引流盘结构的改进等方面对抑制滤过区瘢痕化的方法和研究进展进行综述。

青光眼;青光眼引流植入物;药物缓释系统;滤过道;瘢痕形成;材料改进;结构改进
ABSTRACT

Ahmed glaucoma drainage valve (AGV) implantation is one of the main methods for the treatment of refractory glaucoma with a higher success rate than conventional filtration surgery.However, as a foreign body, the AGV often causes hyperplasia of scar tissue in the filtration area, wrapping around the drainage plate, thereby inhibiting aqueous fluid outflow and causing the intraocular pressure to rise again, leading to surgical failure.Although multiple injections of anti-metabolic drugs during and after AGV implantation can inhibit postoperative scarring, multiple postoperative subconjunctival injections will not only cause discomfort to patients, but also lead to complications.Therefore, it is necessary to improve the AGV to avoid repeated injection of the drug, achieve slow local release of the drug, and reduce the foreign body reaction of AGV at the same time.Recently, the development of new materials, such as Ologen collagen, poly (2-hydroxyethyl methacrylate), poly lactic-co-glycolic acid and opal shale and new techniques provides new methods to inhibit the scarring of filtration area after AGV implantation.This article reviews the methods and progress of inhibition of scar formation in filtration area from the aspects of development of AGV drainage plate materials, construction of drug delivery system of AGV combined with new materials, and improvement of AGV drainage plate structure.

Glaucoma;Glaucoma drainage implants;Drug delivery systems;Filtration area;Scar formation;Material improvement;Structural development
Yuan Huiping, Email: mocdef.6ab213102phnauy
引用本文

江梦璐,董艾萌,原慧萍. 抑制Ahmed青光眼引流阀植入术后滤过区瘢痕化相关研究进展[J]. 中华实验眼科杂志,2024,42(04):397-400.

DOI:10.3760/cma.j.cn115989-20201130-00807

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青光眼是目前全球首位不可逆性致盲眼病 [ 1 ],随着人口增长及老龄化加剧,青光眼患者的数量将日益增加,据统计,到2040年,全球青光眼患者将增加到1.118亿 [ 2 ]。迄今为止,降低眼压被认为是治疗青光眼有效且唯一的手段 [ 3 ],传统的降眼压治疗包括药物治疗、激光治疗和手术治疗,其中经常规滤过性手术联合抗代谢药物治疗,并给予最大耐受量抗青光眼药物后,仍难以将眼压控制在正常范围内的青光眼,统称为难治性青光眼。Ahmed青光眼引流阀(Ahmed glaucoma valve,AGV)已被广泛用于治疗难治性青光眼 [ 4 ],成为其首选治疗方式之一。难治性青光眼经小梁切除术和引流装置植入术后5年的成功率分别为53.1%和70.2% [ 5 ]。然而因患者人群、病情严重程度、植入物和植入手术方式的不同以及伴发眼病的不同,手术成功率也不尽相同。据报道,AGV植入术后3年和5年累计成功率分别为59.4%和45.1% [ 6 ]。分析其远期成功率下降原因,发现植入物作为异物引起特征性伤口愈合反应是手术失败的主要原因,其可导致术后滤过区瘢痕组织增生、包裹引流盘、抑制房水外流,导致眼压重新升高 [ 7 ]。本文就AGV植入术后滤过区瘢痕化这一难题,从AGV引流盘材料的发展、AGV联合新型材料药物缓释系统的构建、AGV引流盘结构的改进等方面就抑制AGV植入术后滤过区瘢痕化的相关研究进展进行综述。
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参考文献
[1]
Flaxman SR , Bourne R , Resnikoff S et al. Global causes of blindness and distance vision impairment 1990-2020:a systematic review and meta-analysis[J/OL]Lancet Glob Health 20175(12)∶e1221-e1234[2023-08-10]https://pubmed.ncbi.nlm.nih.gov/29032195/. DOI: 10.1016/S2214-109X(17)30393-5 .
返回引文位置Google Scholar
百度学术
万方数据
[2]
Tham YC , Li X , Wong TY et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040:a systematic review and meta-analysis[J]Ophthalmology 2014121(11)∶2081-2090. DOI: 10.1016/j.ophtha.2014.05.013 .
返回引文位置Google Scholar
百度学术
万方数据
[3]
Chang EE , Goldberg JL . Glaucoma 2.0:neuroprotection,neuroregeneration,neuroenhancement[J]Ophthalmology 2012119(5)∶979-986. DOI: 10.1016/j.ophtha.2011.11.003 .
返回引文位置Google Scholar
百度学术
万方数据
[4]
Moschos MM , Nitoda E , Gouliopoulos N et al. The choice of drainage device in complicated glaucomas:comparing Ahmed and Baerveldt implants[J]In Vivo 201933(3)∶911-916. DOI: 10.21873/invivo.11558 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
Gedde SJ , Schiffman JC , Feuer WJ et al. Treatment outcomes in the tube versus trabeculectomy (TVT) study after five years of follow-up[J]Am J Ophthalmol 2012153(5)∶789-803. DOI: 10.1016/j.ajo.2011.10.026 .
返回引文位置Google Scholar
百度学术
万方数据
[6]
Luzu J , Baudouin C , Hamard P The role of Ahmed glaucoma valve in the management of refractory glaucoma:long-term outcomes and complications[J]Eur J Ophthalmol 202131(5)∶2383-2389. DOI: 10.1177/1120672120968733 .
返回引文位置Google Scholar
百度学术
万方数据
[7]
Bank RA . Limiting biomaterial fibrosis[J/OL]Nat Mater 201918(8)∶781[2023-08-10]https://pubmed.ncbi.nlm.nih.gov/31332318/. DOI: 10.1038/s41563-019-0428-y .
返回引文位置Google Scholar
百度学术
万方数据
[8]
Van de Velde S , Van Bergen T , Vandewalle E et al. Modulation of wound healing in glaucoma surgery[J]Prog Brain Res 2015221319-340. DOI: 10.1016/bs.pbr.2015.05.002 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
DiEgidio P , Friedman HI , Gourdie RG et al. Biomedical implant capsule formation:lessons learned and the road ahead[J]Ann Plast Surg 201473(4)∶451-460. DOI: 10.1097/SAP.0000000000000287 .
返回引文位置Google Scholar
百度学术
万方数据
[10]
Veiseh O , Vegas AJ . Domesticating the foreign body response:recent advances and applications[J]Adv Drug Deliv Rev 2019144148-161. DOI: 10.1016/j.addr.2019.08.010 .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Lockwood A , Brocchini S , Khaw PT . New developments in the pharmacological modulation of wound healing after glaucoma filtration surgery[J]Curr Opin Pharmacol 201313(1)∶65-71. DOI: 10.1016/j.coph.2012.10.008 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
李中秋张孝生卢弘抗青光眼术后滤过泡瘢痕化组织人Tenon囊成纤维细胞的生长特性[J]中华实验眼科杂志 201432(4)∶308-312. DOI: 10.3760/cma.j.issn.2095-0160.2014.04.005 .
返回引文位置Google Scholar
百度学术
万方数据
Li ZQ , Zhang XS , Lu H In vitro growth characteristics of human Tenon capsule fibroblasts from patients with bleb scaring after antiglaucoma filtration surgery [J]Chin J Exp Ophthalmol 201432(4)∶308-312. DOI: 10.3760/cma.j.issn.2095-0160.2014.04.005 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[13]
Lim KS , Allan BD , Lloyd AW et al. Glaucoma drainage devices;past,present,and future[J]Br J Ophthalmol 199882(9)∶1083-1089. DOI: 10.1136/bjo.82.9.1083 .
返回引文位置Google Scholar
百度学术
万方数据
[14]
Molteno AC . New implant for drainage in glaucoma.Clinical trial[J]Br J Ophthalmol 196953(9)∶606-615. DOI: 10.1136/bjo.53.9.606 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
Riva I , Roberti G , Oddone F et al. Ahmed glaucoma valve implant:surgical technique and complications[J]Clin Ophthalmol 201711357-367. DOI: 10.2147/OPTH.S104220 .
返回引文位置Google Scholar
百度学术
万方数据
[16]
Coleman AL , Hill R , Wilson MR et al. Initial clinical experience with the Ahmed glaucoma valve implant[J]Am J Ophthalmol 1995120(1)∶23-31. DOI: 10.1016/s0002-9394(14)73755-9 .
返回引文位置Google Scholar
百度学术
万方数据
[17]
Ishida K , Netland PA , Costa VP et al. Comparison of polypropylene and silicone Ahmed glaucoma valves[J]Ophthalmology 2006113(8)∶1320-1326. DOI: 10.1016/j.ophtha.2006.04.020 .
返回引文位置Google Scholar
百度学术
万方数据
[18]
Lubiński W , Krzystolik K , Gosawski W et al. Comparison of polypropylene and silicone Ahmed ® glaucoma valves in the treatment of neovascular glaucoma:a 2-year follow-up [J]Adv Clin Exp Med 201827(1)∶15-20. DOI: 10.17219/acem/66806 .
返回引文位置Google Scholar
百度学术
万方数据
[19]
Kim J , Allingham RR , Hall J et al. Clinical experience with a novel glaucoma drainage implant[J/OL]J Glaucoma 201423(2)∶e91-97[2023-08-11]https://pubmed.ncbi.nlm.nih.gov/23689073/. DOI: 10.1097/IJG.0b013e3182955d73 .
返回引文位置Google Scholar
百度学术
万方数据
[20]
Bell K , de Padua Soares Bezerra B , Mofokeng M et al. Learning from the past:mitomycin C use in trabeculectomy and its application in bleb-forming minimally invasive glaucoma surgery[J]Surv Ophthalmol 202166(1)∶109-123. DOI: 10.1016/j.survophthal.2020.05.005 .
返回引文位置Google Scholar
百度学术
万方数据
[21]
Lama PJ , Fechtner RD . Antifibrotics and wound healing in glaucoma surgery[J]Surv Ophthalmol 200348(3)∶314-346. DOI: 10.1016/s0039-6257(03)00038-9 .
返回引文位置Google Scholar
百度学术
万方数据
[22]
Yazdani S , Mahboobipour H , Pakravan M et al. Adjunctive mitomycin C or amniotic membrane transplantation for Ahmed glaucoma valve implantation:a randomized clinical trial[J]J Glaucoma 201625(5)∶415-421. DOI: 10.1097/IJG.0000000000000256 .
返回引文位置Google Scholar
百度学术
万方数据
[23]
Amoozgar B , Lin SC , Han Y et al. A role for antimetabolites in glaucoma tube surgery:current evidence and future directions[J]Curr Opin Ophthalmol 201627(2)∶164-169. DOI: 10.1097/ICU.0000000000000244 .
返回引文位置Google Scholar
百度学术
万方数据
[24]
Song M , Lee S , Choe D et al. Clinical andbiological evaluations of biodegradable collagen matrices for glaucoma drainage device implantation[J]Invest Ophthalmol Vis Sci 201758(12)∶5329-5335. DOI: 10.1167/iovs.17-22579 .
返回引文位置Google Scholar
百度学术
万方数据
[25]
Kim TJ , Kang S , Jeoung JW et al. Comparison of 1-year outcomes after Ahmed glaucoma valve implantation with and without Ologen adjuvant[J/OL]BMC Ophthalmol 201818(1)∶45[2023-08-12]https://pubmed.ncbi.nlm.nih.gov/29444665/. DOI: 10.1186/s12886-018-0709-2 .
返回引文位置Google Scholar
百度学术
万方数据
[26]
Sahiner N , Kravitz DJ , Qadir R et al. Creation of a drug-coated glaucoma drainage device using polymer technology: in vitro and in vivo studies [J]Arch Ophthalmol 2009127(4)∶448-453. DOI: 10.1001/archophthalmol.2009.19 .
返回引文位置Google Scholar
百度学术
万方数据
[27]
Schoenberg ED , Blake DA , Swann FB et al. Effect of two novel sustained-release drug delivery systems on bleb fibrosis:an in vivo glaucoma drainage device study in a rabbit model [J/OL]Transl Vis Sci Technol 20154(3)∶4[2023-08-12]https://pubmed.ncbi.nlm.nih.gov/26046006/. DOI: 10.1167/tvst.4.3.4 .
返回引文位置Google Scholar
百度学术
万方数据
[28]
Ponnusamy T , Lawson LB , Freytag LC et al. In vitro degradation and release characteristics of spin coated thin films of PLGA with a "breath figure" morphology [J]Biomatter 20122(2)∶77-86. DOI: 10.4161/biom.20390 .
返回引文位置Google Scholar
百度学术
万方数据
[29]
贾援王宝民Mineralogy and thermal analysis of natural pozzolana opal shale with nano-pores[J]武汉理工大学学报:材料科学英文版 201732(3)∶532-537. DOI: 10.1007/s11595-017-1629-3 .
返回引文位置Google Scholar
百度学术
万方数据
[30]
Dong A , Han L , Shao Z et al. Glaucoma drainage device coated with mitomycin C loaded opal shale microparticles to inhibit bleb fibrosis[J/OL]ACS Appl Mater Interfaces 201911(10)∶10244-10253[2023-08-13]https://pubmed.ncbi.nlm.nih.gov/30689341/. DOI: 10.1021/acsami.8b18551 .
返回引文位置Google Scholar
百度学术
万方数据
[31]
Sussman EM , Halpin MC , Muster J et al. Porous implants modulate healing and induce shifts in local macrophage polarization in the foreign body reaction[J]Ann Biomed Eng 201442(7)∶1508-1516. DOI: 10.1007/s10439-013-0933-0 .
返回引文位置Google Scholar
百度学术
万方数据
[32]
Amoozgar B , Wei X , Hui Lee J et al. A novel flexible microfluidic meshwork to reduce fibrosis in glaucoma surgery[J/OL]PLoS One 201712(3)∶e0172556[2023-08-13]https://pubmed.ncbi.nlm.nih.gov/28301490/. DOI: 10.1371/journal.pone.0172556 .
返回引文位置Google Scholar
百度学术
万方数据
[33]
Fischer NA , Kahook MY , Abdullah S et al. Effect of novel design modifications on fibrotic encapsulation:an in vivo glaucoma drainage device study in a rabbit model [J]Ophthalmol Ther 20209(2)∶279-291. DOI: 10.1007/s40123-020-00242-0 .
返回引文位置Google Scholar
百度学术
万方数据
[34]
Pepakayala V , Stein J , Gianchandani Y Resonant magnetoelastic microstructures for wireless actuation of liquid flow on 3D surfaces and use in glaucoma drainage implants[J/OL]Microsystems & Nanoengineering 20151(1)∶15032[2023-08-20]https://link.springer.com/article/10.1038/micronano.2015.32. DOI: 10.1038/micronano.2015.32 .
返回引文位置Google Scholar
百度学术
万方数据
[35]
郑玉强王卓实徐玲壳聚糖静电纺丝膜对兔球结膜损伤的促修复作用[J]中华实验眼科杂志 201836(2)∶102-106. DOI: 10.3760/cma.j.issn.2095-0160.2018.02.006 .
返回引文位置Google Scholar
百度学术
万方数据
Zheng YQ , Wang ZS , Xu L et al. Promoting repair effects of chitosan/gelatin electrospinning membrane implantation on rabbit conjunctival injury[J]Chin J Exp Ophthalmol 201836(2)∶102-106. DOI: 10.3760/cma.j.issn.2095-0160.2018.02.006 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[36]
Klapstova A , Horakova J , Tunak M et al. A PVDF electrospun antifibrotic composite for use as a glaucoma drainage implant[J/OL]Mater Sci Eng C Mater Biol Appl 2021119111637[2023-08-20]https://pubmed.ncbi.nlm.nih.gov/33321675/. DOI: 10.1016/j.msec.2020.111637 .
返回引文位置Google Scholar
百度学术
万方数据
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