Department of Ophthalmology, University of Florida, Gainesville, Florida, United States of America.
PLoS One. 2018 May 24;13(5):e0196968. doi: 10.1371/journal.pone.0196968. eCollection 2018.
To examine the effect of cannula diameter and conjunctival flap method on bleb survival in rabbits undergoing cannula-based glaucoma filtration surgery (GFS).
Twelve New Zealand White rabbits underwent GFS in both eyes. The twenty-four eyes were divided into four groups. Two of the four groups (N = 12) received limbus-based conjunctival flaps (LBCF), and the other two (N = 12) received fornix-based conjunctival flaps (FBCF). Six FBCF rabbit eyes were implanted with 22-gauge drainage tubes, and the other six were implanted with 26-gauge tubes. Likewise, six LBCF rabbits received 22-gauge drainage tubes and six received 26-gauge tubes. Filtration blebs were evaluated every three days by a masked observer. Bleb failure was defined as the primary endpoint in this study and was recorded after two consecutive flat bleb evaluations.
Group 1 (LBCF, 22- gauge cannula) had a mean bleb survival time (Mean ± SD) of 18.7 ± 2.9 days. Group 2 (LBCF, 26-gauge cannula) also had a mean bleb survival time of 18.7 ± 2.9 days. Group 3 (FBCF, 22-gauge cannula) had a mean bleb survival time of 19.2 ± 3.8 days. Group 4 (FBCF, 26-gauge cannula) had a mean bleb survival time of 19.7 ± 4.1 days. A 2-way analysis of variance showed that neither surgical approach nor cannula gauge made a statistically significant difference in bleb survival time (P = 0.634 and P = 0.874). Additionally, there was no significant interaction between cannula gauge and conjunctival flap approach (P = 0.874), suggesting that there was not a combination of drainage gauge and conjunctival flap method that produced superior bleb survival.
Limbus and fornix-based conjunctival flaps are equally effective in promoting bleb survival using both 22 and 26-gauge cannulas in the rabbit model. The 26-gauge drainage tube may be preferred because its smaller size facilitates the implantation process, reducing the risk of corneal contact.
研究套管直径和结膜瓣方式对兔眼套管法青光眼滤过手术（GFS）中滤过泡存活的影响。
12 只新西兰白兔双眼均行 GFS。24 只眼分为 4 组。其中 2 组（N=12）行缘部基底部结膜瓣（LBCF），另外 2 组（N=12）行穹窿部基底部结膜瓣（FBCF）。6 只 FBCF 兔眼植入 22G 引流管，另外 6 只植入 26G 引流管。同样，6 只 LBCF 兔眼植入 22G 引流管，6 只植入 26G 引流管。术后每 3 天由一名蒙眼观察者评估滤过泡。滤过泡失败定义为本研究的主要终点，在连续 2 次扁平滤过泡评估后记录。
第 1 组（LBCF，22G 套管）的平均滤过泡存活时间（Mean ± SD）为 18.7 ± 2.9 天。第 2 组（LBCF，26G 套管）也有 18.7 ± 2.9 天的平均滤过泡存活时间。第 3 组（FBCF，22G 套管）的平均滤过泡存活时间为 19.2 ± 3.8 天。第 4 组（FBCF，26G 套管）的平均滤过泡存活时间为 19.7 ± 4.1 天。双因素方差分析显示，手术方式或套管规格均不能显著影响滤过泡存活时间（P=0.634 和 P=0.874）。此外，套管规格和结膜瓣方式之间也没有显著的交互作用（P=0.874），这表明没有一种联合引流管规格和结膜瓣方式可以产生更好的滤过泡存活。
在兔模型中，22G 和 26G 套管均能有效应用缘部和穹窿部基底部结膜瓣，两种结膜瓣方式对滤过泡存活的影响无差异。26G 引流管的尺寸更小，有利于植入过程，减少角膜接触的风险，因此可能更具优势。
