论文部分内容阅读
目的 探讨选择性激光小梁成形术 (SLT)的优越性及可能的作用机制。方法 选取因恶性肿瘤而摘除的人眼球 5只 ,经检查房角结构正常 ,摘除后立即行SLT和氪绿激光小梁成形术 ,每只眼球的颞侧做 180°范围的SLT ,Q 开关Nd∶YAG激光波长 5 32nm ,光斑直径 4 0 0 μm ,每脉冲持续 3ns,能量为 1 5～ 2 1mJ,总能量 5 2 4 6mJ,共 5 0个非重叠光斑。每只眼的鼻侧 180°范围做氪绿激光 (5 2 1nm)小梁成形术 ,光斑直径 5 0 μm ,脉冲时间 0 1s ,总能量6 0 0～ 80 0mJ,共 5 0个光斑。术后取小梁组织制成切片 ,于光镜和电镜下进行观察比较。结果 两种激光均能有效地进行小梁成形术 ,但SLT对小梁损伤小 ,且仅对色素性小梁内皮细胞起作用 ,对非色素细胞无损伤作用。氪绿激光小梁成形术则破坏小梁网细胞。结论 SLT治疗开角型青光眼安全有效 ,损伤小 ,其房水流出量的增加可能与激光刺激小梁干细胞 ,使其参与小梁结构重建 ,恢复小梁正常功能 ,增强滤过有关。
Objective To investigate the superiority and possible mechanism of selective laser trabeculoplasty (SLT). Methods Five human eyeballs were selected from malignant tumors. After examining the normal angle structures, SLT and krypton green laser trabeculoplasty were performed immediately after the removal. The 180 ° SLT was performed on the temporal side of each eyeball. The Q-switched Nd : YAG laser wavelength 5 32nm, spot diameter 400μm, pulse duration 3ns, energy of 15 ~ 21mJ, a total energy of 5 2 4 6mJ, a total of 50 non-overlapping spots. The nasal side of each eye 180 ° krypton green laser (521nm) trabeculoplasty, spot diameter of 50μm, pulse time 0 1s, the total energy 600 ~ 80 0mJ, a total of 50 spots. After trabecular tissue was made into slices, observed under light and electron microscopy. Results Both laser beams were effective in trabeculoplasty. However, SLT lessened trabecular injury and played a role only in pigmented trabecular epithelial cells and non-injury to non-pigmented cells. Krypton Green laser trabeculoplasty destroys the trabecular meshwork cells. Conclusions SLT is safe and effective in treating open-angle glaucoma. The increase of aqueous humor outflow may be related to laser-induced trabecular stem cells, which may be involved in the reconstruction of trabecular meshwork, restoring the normal function of trabeculae and enhancing filtration.