Аутотрансплантация жировой ткани в профилактике рубцевания после непроникающей антиглаукомной операции

Рубцевание фильтрационной зоны остается главным ограничением долгосрочного успеха непроникающей антиглаукомной операции. Для фильтрующей антиглаукомной операции (НПАГХ) важны не только состояние субконъюнктивального пространства, но и функциональность трабекуло-десцеметовой мембраны, стабильность объема интрасклеральной полости и контролируемое заживление послеоперационной раны. Цель работы — сформировать клинико-патогенетическую модель рубцевания после НПАГХ и оценить, может ли аутотрансплантация жировой ткани рассматриваться как инструмент селективной иммунорегулируемой антипролиферации. Обзор выполнен в формате структурированного обзора с трансляционной направленностью на основе обзора публикаций по состоянию на март 2026 г. Анализ литературы показывает, что для НПАГХ принципиально важно не максимальное подавление клеточной активности, а управление ходом заживления. Речь идет о контроле персистирующего воспаления, TGF-b-зависимых путей, миофибробластической трансформации, ремоделирования внеклеточного матрикса и механической стабилизации фиброза. Перспективы использования жировой ткани обусловлены ее комплексным воздействием в зоне аутотрансплантации: модуляцией локального воспаления, антифибротическим эффектом, ингибированием синтеза внеклеточного матрикса, нейтрализацией матричных металлопротеиназ.

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