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在两种动物模型和人类供体眼中进行实验性青光眼微支架植入术——基于微型计算机断层扫描的适用性评估

Experimental glaucoma microstent implantation in two animal models and human donor eyes-an micro-computed tomography-based evaluation of applicability.

作者信息

Runge Jens, Kischkel Sabine, Keiler Jonas, Grabow Niels, Schmitz Klaus-Peter, Siewert Stefan, Wree Andreas, Guthoff Rudolf F, Stahnke Thomas

机构信息

Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany.

Institute of Anatomy, Rostock University Medical Center, Rostock, Germany.

出版信息

Quant Imaging Med Surg. 2024 Aug 1;14(8):5321-5332. doi: 10.21037/qims-23-905. Epub 2024 Jan 22.

Abstract

BACKGROUND

Minimally invasive glaucoma surgery (MIGS) has become an important treatment approach for primary open angle glaucoma. Restoration of aqueous humour drainage by means of alloplastic implants represents a promising treatment option and is itself subject of methodological development. An adequate positioning in the targeted tissue regions is essential is important for the performance of our in-house developed Rostock glaucoma microstent (RGM). The aim of this study was to evaluate the applicability of two animal models and human donor eyes regarding RGM placement.

METHODS

Eyes were obtained from rabbits, pigs, and human body donations. After orbital exenterations, RGMs were placed in the anterior chamber draining in the subconjunctival space. X-ray contrast was increased by incubation in aqueous iodine solution for subsequent detailed micro-computed tomography (micro-CT)-based visualization and analysis.

RESULTS

In contrast to the human and porcine eyes, the stent extended far to the posterior pole with a more pronounced curvature along the globe in the rabbit eyes due to their smaller size. However, dysfunctional deformations were not depicted. Adequate positioning of the stent's inflow area in the anterior chamber and the outflow area in the Tenon space was achieved in both the animal models and the human eye.

CONCLUSIONS

Micro-CT has proven to be a valuable tool for postoperative evaluation of glaucoma drainage devices in its entire complexity. With regard to morphology, the porcine eye is the ideal animal model to test implantation procedures of the RGM. Nevertheless, rabbit eye morphology facilitates successful implantation results and provides all prerequisites for preclinical animal studies.

摘要

背景

微创青光眼手术(MIGS)已成为原发性开角型青光眼的一种重要治疗方法。通过异体植入物恢复房水引流是一种有前景的治疗选择,其本身也在经历方法学的发展。在目标组织区域进行适当定位对于我们自主研发的罗斯托克青光眼微支架(RGM)的性能至关重要。本研究的目的是评估两种动物模型和人类供体眼在RGM植入方面的适用性。

方法

从兔子、猪和人体捐赠中获取眼睛。在眼眶摘除术后,将RGM植入前房并引流至结膜下间隙。通过在碘化水溶液中孵育增加X射线对比度,以便随后基于详细的微型计算机断层扫描(micro-CT)进行可视化和分析。

结果

与人和猪的眼睛相比,由于兔子眼睛尺寸较小,支架在兔子眼中向眼球后极延伸得更远,沿着眼球的弯曲更明显。然而,未发现功能失调的变形。在动物模型和人眼中,均实现了支架流入区域在前房的适当定位以及流出区域在Tenon间隙的适当定位。

结论

事实证明,Micro-CT是一种用于全面评估青光眼引流装置术后情况的有价值工具。就形态学而言,猪眼是测试RGM植入程序的理想动物模型。尽管如此,兔眼形态有助于成功的植入结果,并为临床前动物研究提供了所有先决条件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd57/11320535/736a563b7bb4/qims-14-08-5321-f1.jpg

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