НЕАДЕКВАТНАЯ РЕПАРАТИВНАЯ РЕГЕНЕРАЦИЯ В ФИСТУЛИЗИРУЮЩЕЙ ХИРУРГИИ ГЛАУКОМЫ

Oftal mokhirurgiya

Т. Н. Юрьева²  Н. В. Волкова²  А. Г. Щуко²  Ю. В. Малышева² 

[1] Иркутская государственная медицинская академия последипломного образования;Иркутский филиал МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова

关键词: Glaucoma;    hyperscarring;    postoperative healing;    modulators of healing;    non-penetrating deep sclerectomy;    trabeculectomy;    filtering surgery;    глаукома;    гиперрубцевание;    послеоперационное заживление;    модуляторы заживления;    непроникающая глубокая склерэктомия;    трабекулэктомия;    фильтрационная хирургия;   

DOI  :  10.25276/0235-4160-2014-3-60-66

学科分类：眼科学

来源: M H T K Mikrokhirurgiya Glaza

【 摘 要 】

Purpose.To reveal predictors of development and clinical manifestations of the syndrome of inadequate reparative regeneration after the fistulazing glaucoma surgery. Material and methods.A retrospective analysis was performed based on 450 protocols of surgery of filtering type. Then the indices of visual system and homeostasis were examined in patients after non-penetrating deep sclerectomy in groups with viable intraocular aqueous outflow pathways (n=38) and hyperscarring (n=33). Predictors of inadequate reparative regeneration syndrome were revealed. Results and discussion.Signs, differentiating the local ophthalmological status, were detected: the preoperative IOP level ≥35mmHg, the 2nd and 3rd degrees of irido-ciliary dystrophic changes, the subnormal nature of the ERG. Indices, differentiating the somatic status, were as follows: an increased level of neutrophils, triacylglycerols, cholesterol of very low density lipoproteins, cholesterol of low density lipoprotein, C-reactive protein, atherogenic index of follicle stimulating hormone and dehydroepialdosterone in patients with syndrome of inadequate reparative regeneration. It allowed defining predictors and clinical signs of inadequate reparative regeneration syndrome and failure of intraocular aqueous outflow pathways, as the outcome of fistulazing antiglaucomatous interventions. Conclusion.Identified predictors of hyperscarring obviously influence on a transformation of healing process phases that clearly requires a further study. Clinical signs of inadequate reparative regeneration syndrome are a pronounced exudative reaction of inflammation phase, signs of active compensatory angiogenesis and fibroplasia, manifested by dysfunction and formation of pathological filtering bleb with/without IOP decompensation. However, the timely and etiopathogenetic treatment optimizes the morphogenesis of outflow pathways and increases the efficiency of fistulazing antiglaucomatous interventions.

【 授权许可】

CC BY