Application of paclitaxel during trabeculectomy and its anti-proliferative effects / 中华实验眼科杂志

ABSTRACT

Background The filtering surgery is the main method of treating glaucoma.Fibrosis of filtering bleb is a key cause of failure of operation.The study about application of anti-scaring drug in filtering surgery is a hotspot.Objective Present study was to investigate the anti-scaring effect of paclitaxel aher trabeculectomy.Methods Thirty-two adult clean domestic rabbits underwent standardized trabeculectomy and randomly divided into 4 groups.Normal saline solution was used beneath the scleral flap during trabeculectomy for 3 minutes in 16 eyes of 8 rabbits as controls.0.3 g/L mitomycin C,0.2 g/L paclitaxel or 0.3 g/L paclitaxel was administered at the same way respectively in other 3 groups.Intraocular pressure (IOP) was measured,and eye numbers with function blebs were compared among 4 groups at the 4th,7th,14th and 28th day after surgery.The opening of filtration tunnel and the number of inflammatory cells were observed by hematoxylin and eosin staining,and proliferation of new collagen fibers was evaluated by Masson trichrome method.This study complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission(version 1988). Results No significant differences were found in the change of lOP among 4 groups before operation(F=0.54,P=0.83)and the 4th day aher operation(F=0.57,P=0.87).The IOP value was statistically lower in 0.3 g/L mitomycin C group,0.2 g/L paclitaxel group and 0.3 s/L paelitaxel group than the normal saline solution group(P＜0.05)with the lowest value in 0.3 s/L paclitaxel group in 7,14,28 days after operation(P＜0.05).Functional filtering bleb was seen in all the rabbit eyes in the 4th day after operation.In 7,14,28 days after operation,the number of eyes with functional bleb wag evidently more in 0.3 g/L mitomycin C group,0.2 g/L paclitaxel group and 0.3 g/L paclitaxel group compared with normal saline group(P＜0.05).The histological examination showed that the infiltration of inflammatory cells in filtering tunnel was much more obvious in normal saline solution group than the other groups with the most mild response in 0.3 g/L paclitaxel group.Masson trichrome revealed that proliferation of new collagen fibers in 0.3 g/L paclitaxel group was significantly decreased in comparison with those in other three groups at the 4th,7th,14th and 28th day after surgery(all P＜0.05). Conclusion Paclitaxel can inhibit the inflammatory response and collagen fibrosis and therefore open the filtering tunnel after it be used topically during the glaucoma trabeculectomy.