Lloyd M A, Baerveldt G, Nguyen Q H, Minckler D S
Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles, USA.
J Glaucoma. 1996 Oct;5(5):334-9.
The Baerveldt glaucoma implant is an aqueous shunting device with large surface area that is installed through a single-quadrant conjunctival incision. A rabbit model of the Baerveldt implant was created to obtain serial histology and clinical information over 1 year.
Modified versions of the Baerveldt implant (110 or 160 mm2) were implanted in 18 normal New Zealand white rabbit eyes. The rabbits were examined periodically and their intraocular pressures (IOPs) recorded. They were killed at monthly intervals to obtain histology of the bleb capsules.
Thin capsules were present at 1 month, which consisted of lamellar collagen deposition surrounded by a granulomatous reaction with multinucleate giant cells. Inflammatory cells (probably macrophages) were scattered on the inner bleb surface. The granulomatous reaction resolved after 4 months. Subsequently, capsule thickness and cellularity remained relatively stable, although the collagen stroma became less compact over time. Sixteen rabbit eyes had initial IOP reductions of > or = 3 mm Hg compared with fellow eyes, which persisted up to 4 weeks postoperatively. Seven eyes (39%) exhibited a hypertensive phase (IOP exceeded that of fellow eye by > or = 3 mm Hg) from 2 weeks to 3 months postoperatively.
The Baerveldt explant is surrounded by a fibrous capsule that matures over time. The bleb histology in the rabbit model is similar to that described with the Molteno implant in primates and humans, except for the eventual development of a fibroblastic inner lining in the rabbit model. This contrasts with primate and human models, in which the inner lining remains an open mesh.
Baerveldt青光眼植入物是一种具有大表面积的房水引流装置，通过单象限结膜切口植入。建立了Baerveldt植入物的兔模型，以获取1年以上的系列组织学和临床信息。
将改良版的Baerveldt植入物（110或160平方毫米）植入18只正常新西兰白兔眼。定期检查兔子并记录其眼压（IOP）。每隔一个月处死兔子以获取泡状囊的组织学。
1个月时存在薄囊，其由层状胶原沉积组成，周围有伴有多核巨细胞的肉芽肿反应。炎性细胞（可能是巨噬细胞）散在于泡状囊内表面。肉芽肿反应在4个月后消退。随后，囊厚度和细胞密度保持相对稳定，尽管胶原基质随时间变得不那么致密。与对侧眼相比，16只兔眼的初始眼压降低≥3 mmHg，术后持续长达4周。7只眼（39%）在术后2周 至3个月出现高血压期（眼压超过对侧眼≥3 mmHg）。
Baerveldt植入物被随着时间成熟的纤维囊包围。兔模型中的泡状囊组织学与灵长类动物和人类中Molteno植入物所描述的相似，除了兔模型中最终出现成纤维细胞内衬。这与灵长类动物和人类模型形成对比，在灵长类动物和人类模型中，内衬保持开放网状结构。
