Molteno Anthony C B, Suter Antony J, Fenwick Mark, Bevin Tui H, Dempster Alex G
Ophthalmology Section, Medical and Surgical Sciences, University of Otago Dunedin School of Medicine, Dunedin, New Zealand.
Invest Ophthalmol Vis Sci. 2006 May;47(5):1975-81. doi: 10.1167/iovs.05-0988.
To describe the cytology and immunohistochemistry of Molteno implant capsules from cases of primary and secondary glaucoma.
Histologic features of capsules including cell cytology, the distribution of activated (proliferating) cells, apoptosing cells, and membrane bound vesicles (presumed death messengers) were assessed by light microscopy and correlated with clinicopathological features in 10 noninflamed eyes with good intraocular pressure control (nine autopsy and one enucleation) obtained from 2 months to 16.8 years after insertion of Molteno implants.
All bleb capsules demonstrated two distinct layers. The thin external layer was cellular with fairly numerous small blood vessels coursing through normally staining, regularly arranged collagen fibers. The thicker, deeper layer was avascular, relatively acellular, and characterized by regularly arranged swollen and fragmented collagen fibers. Most cells in the external layer appeared normal; however, between 5% (in recently formed blebs) and approximately 50% (in well established blebs) showed cytological and/or immunohistochemical changes characteristic of metabolic activation and/or apoptosis. All cells in the deeper layer, regardless of time after surgery, also demonstrated cytological and/or immunohistochemical staining characteristic of metabolic activation and/or apoptosis. In addition, the deeper layer evidenced large numbers of minute membrane-bound vesicles (presumed death messengers).
The balance between activation and apoptosis regulates the thickness and permeability of bleb capsules, and the normal lifecycle of bleb capsules includes continual inner surface degeneration and external surface renewal.
描述原发性和继发性青光眼病例中莫尔顿植入物囊膜的细胞学和免疫组织化学特征。
通过光学显微镜评估囊膜的组织学特征，包括细胞细胞学、活化（增殖）细胞、凋亡细胞和膜结合囊泡（推测为死亡信使）的分布，并将其与10只眼压控制良好的非炎症性眼睛（9例尸检和1例眼球摘除）的临床病理特征相关联，这些眼睛在植入莫尔顿植入物后2个月至16.8年获得。
所有滤过泡囊膜均显示出两个不同的层。薄的外层有细胞，有相当多的小血管穿过正常染色、规则排列的胶原纤维。较厚、较深的层无血管，细胞相对较少，其特征是胶原纤维肿胀和断裂且规则排列。外层的大多数细胞看起来正常；然而，5%（在新形成的滤过泡中）至约50%（在成熟的滤过泡中）表现出代谢活化和/或凋亡的细胞学和/或免疫组织化学变化。无论手术后时间如何，较深层的所有细胞也表现出代谢活化和/或凋亡的细胞学和/或免疫组织化学染色特征。此外，较深层有大量微小的膜结合囊泡（推测为死亡信使）。
活化与凋亡之间的平衡调节滤过泡囊膜的厚度和通透性，滤过泡囊膜的正常生命周期包括内表面持续退化和外表面更新。
