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HeNe laser machine is the first manufactured continuous emission gas laser, and is the most reliable one. It is widely used because of its portability. The working substances are helium and neon, and neon is the working gas. The laser is produced by neon atom, and mainly stimulates three wavelength, 632.8nm, 1.15μm and 3.39μm. The output power of laser is low, 0.1100mW generally. Organism exposed into HeNe laser will not result in nonreversible tissue damage, so it is safe[79].
According to the research, HeNe laser impact on organism is related to its power and energy density. Low dose HeNe laser radiation promotes the fibroblast proliferation and collagen synthesis, and cause wound healing. High dose HeNe laser radiation inhibits the fibroblast proliferation and promotes apoptosis[1014]. This research uses high level dose of HeNe laser to study its influence on the scar formation of the filtration canal.
CTGF is new discovered fibrosis factor in the 1990s, is a polypeptide rich in cysteine, and a member of CNN family. CTGF is widely expressed in many human tissues and cells, such as heart, brain, lung, kidney, placenta, pancreas and connective tissue. Its main functions are: promote cell proliferation and collagen synthesis, induce cell adhesion and chemotaxis, and facilitate blood vessel and granulation tissue formation. CTGF is none or extremely low expression in normal tissue[15]. But CTGF is closely related to some hyperplastic and fibrosis diseases in pathologic status. Many researches approved that CTGF expression is positive correlation to the degree of fibrosis[16]. As the important substance
Figure 1 CTGF expression of fibroblast in the filtration site (×400, arrow pointed are positive cells) A: Laser group on the 7th day after surgery: a small amount of CTGF positive cells in filtration site; B: Control group on the 7th day after surgery: a lot of positive cells in filtration site, and they are stained darker; C: Laser group on the 14th day after surgery: few CTGF positive cells in filtration site and stained lighter compare to the 7th day group; D: Control group on the 14th day after surgery: a small amount of CTGF positive cells in filtration site, and stained lighter compare to the 7th day group; E and F are laser and control group on the 28th day after surgery: a extremely small amount of CTGF positive cells in filtration site.
Figure 2 Arrow pointed is the filtration site, and blue stained tissue is collagen fiber (×200) A and B are laser and control group on the 14th day; C and D are laser and control group on the 28th day, and the collagen expression is higher in laser group.
of ECM, collagen is secreted by fibroblast, and its degree of proliferation can reveal the degree of scar formation.
The research shows that the fibroblast proliferation and collagen synthesis are most active on the 7th day after surgery, the activity went down on the 14th day, and went normal on the 28th day. All above are accord with the post surgery inflammatory process, is the same as the literature report[1719]. The research result points out that the pretreatment with the HeNe laser can improve the success rate of the filtration surgery significantly, represented by the good condition of the filtration bubble. This could be the result of HeNe laser downgrade the fibroblast CTGF expression and the activity of fibroblast proliferation and collagen synthesis, reduce the inflammatory reaction, and scar formation of filtration canal.
The mechanism of HeNe laser inhibit the proliferation of cell is not completely clear. Its impact on the proliferation and apoptosis of cell, and the safety of using HeNe laser on ocular need more study.
In conclusion, the HeNe laser with 200mW/cm2 power density can reduce the scar formation of rabbit ocular after the filtration surgery; it could be related to the downgrading of fibroblast CTGF expression and collagen synthesis. It is possible the HeNe laser could be a brandnew way to improve the success rate of filtration surgery.
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