Effects of intraoperative oxidated regenerated cellulose on wound healing reaction after glaucoma filtration surgery: a comparative study with Interceed and Surgicel.

BACKGROUND: The successful lowering of the intraocular pressure after glaucoma filtration surgery depends mostly on the nature of the healing response, which is also the single most important modifiable factor. AIMS: To evaluate and compare the effectiveness of two oxidated regenerated cellulose material, Interceed and Surgicel on wound healing reaction after glaucoma filtration surgery. SETTING AND DESIGN: University hospital, prospective study. MATERIALS AND METHODS: Full thickness filtration surgery was carried out on three groups of rabbits. Interceed and Surgicel was applied in Groups 1 and 2 respectively. The third group was the controls. Intraocular pressure, anterior chamber depth and bleb appearance were checked on the first, third, seventh and 14 th days. The rabbits were sacrificed on the 14 th day and the trabeculectomy area with overlying conjunctiva was excised, fixed, stained and evaluated histopathologically. STATISTICS: The values obtained from the clinical and histopathologic evaluation were statistically analyzed using non-parametric tests (Mann Whitney-U and Kruskall Wallis tests) in SPSS for Windows v-10. P values under 0.05 for statistical significance in comparisons were considered significant. RESULTS: The groups were similar with respect to intraocular pressure, anterior chamber depth, bleb appearance and number of the fibroblasts and neutrophils on the seventh and 14 th days. Mean number of the eosinophils and vessels was significantly less in Groups 1 and 2 ( P = 0.014, P = 0.20 respectively). Macrophages in Group 2 were significantly less than Group 1 ( P = 0.047). CONCLUSION: Both these agents seem to suppress vascularization. Since they have no significant effect on fibroblast proliferation, it is controversial to talk about wound healing modulation.

Effects of octreotide acetate and amniotic membrane on wound healing in experimental glaucoma surgery.

Wound healing affects the success of glaucoma filtering surgery. Antimetabolites and antifibrotic agents are used in the modulation of surgical trauma. This study is performed to evaluate the effects of amniotic membrane and octreotide acetate on wound healing. Thirty pigmented rabbits were divided into three groups each including 10 animals. Trabeculectomy and topical postoperative prednisolone sodium phosphate four times daily for 7 days were applied to one eye of all the rabbits. After trabeculectomy, octreotide 10 microg three times daily applied topically to the octreotide group for 14 days and amniotic membrane transplantation was performed by suturing amniotic membrane between scleral flap and sclera to the amniotic membrane group. The operated eyes of the rabbits were enucleated on the 14th day of the operation and histopathological specimens were obtained from the bleb sites and they were evaluated by light microscope. Fibroblast and macrophage number per cm2 were counted and the average values were calculated. Compared with the control group, the fibroblasts and macrophages significantly decreased in the other two groups (p < 0.0001, p < 0.0001, respectively). The mean number of fibroblasts was lower than those of the control and amniotic membrane groups (p < 0.0001, p < 0.0001, respectively). Similarly the mean macrophage number was significantly lower in the octreotide group versus the control and amniotic membrane groups (p < 0.0001, p < 0.01, respectively). Octreotide administration and amniotic membrane transplantation might be alternative treatments in modulating the wound healing after trabeculectomy.

Ciliary body toxicity of cyclosporin A and octreotide acetate in rabbit eyes: a comparison with mitomycin C and 5-fluorouracil.

PURPOSE: To compare the toxicities of cyclosporin A, octreotide acetate, mitomycin C and 5-fluorouracil to the ciliary body. METHOD: We applied sponges soaked in these compounds to the open scleras of rabbit eyes. Histopathological specimens were obtained from the operation site and at 180 degrees from it on the 14th day after surgery. RESULTS: Mean ciliary epithelial thickness in the study groups was as follows: 12.29 +/- 2.69 microm in group 1 (mitomycin C), 13.85 +/- 4.56 microm in group 2 (5-fluorouracil), 17.71 +/- 3.09 microm in group 3 (cyclosporin A), 11.64 +/- 2.92 microm in group 4 (octreotide acetate), 11.92 +/- 2.89 microm in group 5 (topically applied octreotide acetate) and 21.85 +/- 4.29 microm in group 6 (control). The ciliary epithelial thickness in groups 1, 2, 4 and 5 was statistically different from that in the control group. Intracellular vacuolisation and degenerative changes of the non-pigmented epithelium, and pigment loss of the pigmented epithelium, were found mostly in group 1 and moderately in group 2 and 3. CONCLUSION: Octreotide acetate and cyclosporin A are less toxic alternatives to mitomycin C and 5-fluorouracil in glaucoma filtration surgery.

Effects of amniotic membrane transplantation and mitomycin C on wound healing in experimental glaucoma surgery.

PURPOSE: To evaluate the effects of mitomycin C and amniotic membrane transplantation on the modulation of wound healing after glaucoma filtration surgery. METHODS: Trabeculectomy was performed in 3 groups of 10 rabbit eyes each. Sponges soaked in mitomycin C were applied to the first group, and amniotic membranes were transplanted around the scleral flap in the second group; the third group was the control. The arithmetic means of fibroblast and macrophage numbers per square centimetre were calculated. RESULTS: The mean numbers of fibroblasts and macrophages were decreased significantly in the mitomycin C group, compared with the controls (p < 0.0001). Cell counts in the amniotic membrane group were also lower than the ones in the control group for fibroblasts and macrophages (p < 0.0001, p < 0.01, respectively). The difference between the two treatment groups was statistically significant for fibroblasts (p < 0.0001), but not significant for macrophages (p > 0.05). CONCLUSION: In spite of the fact that amniotic membrane transplantation is less effective than mitomycin C for depressing wound healing after trabeculectomy, it might be a safer alternative in selected cases when considering severe adverse effects of antimetabolites.