摘要青光眼手术失败的主要原因是由于瘢痕组织形成导致滤过泡发生纤维化.尽管抗纤维化药物如丝裂霉素C和5-氟尿嘧啶可明显改善手术成功率,其潜在术后并发症问题难以令人满意.近年来,开发的一些新的药物、材料或手段,尤其是交联透明质酸钠尤为引人瞩目.交联透明质酸钠减少瘢痕形成的作用机制,在于其物理屏障效应和本身所具有的抗炎特性的直接或间接作用;交联性状可使其降解时间延长.临床初步研究显示,交联透明质酸钠在青光眼手术中的应用对控制眼压和减少术后瘢痕化均具有较好效果.

abstractsScar tissue deposition,which results in fibrosis of the formatted functional structures such as bleb,is the most frequent cause of glaucoma operation's failure.Although antifibrotic agents such as mitomycin C and 5-fluorouracil have significantly improved the efficacy of the operation,concerns remain regarding the potential increases in postoperative complications.Various novel or newer pharmacological substances have been developed in recent years with different ways to modulate the wound healing after the surgery,of which cross-linked or reticulated hyaluronate appears particular attractive.It is suggested that the mechanisms of scare formation-minimizing effect of cross-linked or reticulated hyaluronate are largely attributed to its space-occupying and inherent anti-inflammatory properties directly and indirectly,and the crosslinked format confers it with a slower degrading time.The preliminary results of its clinical application in glaucoma surgery are promising in term of both controlling intraocular pressure and decreasing postoperative complications.