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生物可降解胶原基质治疗青光眼引流装置的临床和生物学评估 Clinical and Biological Evaluations of Biodegradable Collagen Matrices for Glaucoma Drainage Device Implantation

Song, M., Lee, S., Choe, D., Kim, S., Roh, Y.H., Rho, S.

期刊名称:Investigative Ophthalmology & Visual Science

卷期:2017年第58卷第12期

摘要

摘要:目的:旨在描述生物可降解胶原基质(BCMs)的临床和生物学特性,为青光眼引流装置植入提供依据。方法:回顾性研究后连续招募了难治性青光眼68只,术后随访至少6个月。使用我们的Ologen-6Ologen-7阀进行BCM增强Ahmed阀植入(BAAVI),并与传统方法进行比较。完全手术成功定义为没有抗青光眼药物的情况下,眼压≤21 mm HgIOP 1)或≤17 mm HgIOP 2)。合格的成功定义为眼压≤21毫米汞柱,有或没有抗青光眼药物。通过眼生理条件下胶原酶酶降解速率评估每个BCM的生物学性质。结果:各组的平均年龄和术前眼压相似。常规BAOI联合Ologen-6BAAVI联合Ologen-7组,目标IOP1的成功率分别为29.2%,40.0%和66.7%。目标IPO2分别为12.5%,30.0%和45.8%;合格的成功率分别为45.8%,55.0%和75.0%。 Ologen-7的酶降解速率明显低于Ologen-612.5×10-328.8×10-3)。结论:与常规和Ologen-6 BAAVI组相比,Ologen-7 BAAVI组的手术成功率最高,对术后抗青光眼药物的依赖性最低。临床结果与基于酶降解程度和结构形态的不同生物学和物理化学性质相关。

Purpose:To characterize the clinical and biological properties of biodegradable collagen matrices (BCMs) for possible glaucoma drainage device implantation.Methods:A total of 68 refractory glaucoma eyes, followed up postoperatively for at least 6 months, were consecutively enrolled after retrospective chart review. The BCM-augmented Ahmed valve implantations (BAAVI) using our Ologen-6 and Ologen-7 valves were performed and compared with a conventional method. Complete surgical success was defined as an IOP of 21 mm Hg (IOP 1) or 17 mm Hg (IOP 2) without antiglaucoma medications. Qualified success was defined as an IOP 21 mm Hg with or without antiglaucoma medications. The biological properties of each BCM were assessed by enzymatic degradation rates via collagenase under ocular physiological conditions.Results:The mean ages and preoperative IOPs were similar for the groups. In the conventional, BAAVI with Ologen-6, and BAAVI with Ologen-7 groups, complete success rates with target IOP 1 were 29.2%, 40.0%, and 66.7%; those with target IOP 2 were 12.5%, 30.0%, and 45.8%; qualified success rates were 45.8%, 55.0%, and 75.0%, respectively. The enzymatic degradation rate of Ologen-7 was significantly slower than that of Ologen-6 (12.5 × 10-3 vs. 28.8 × 10-3).Conclusions:The surgical success rate was highest in the Ologen-7 BAAVI group, with the lowest dependency on postoperative antiglaucoma medication use compared with the conventional and Ologen-6 BAAVI groups. The clinical results correlated with the different biological and physicochemical properties based on the degree of enzymatic degradation and on the structural morphology.


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