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Tatsuo Nagata, Yukinori Harada, Hiroyuki Kondo, Mikki Arai, Akihiko Tawara; Repairing filtration bleb leakage with FocalSeal® in rabbit model. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4772.
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© ARVO (1962-2015); The Authors (2016-present)
The bleb leakage is regarded as a risk of bleb infection, which is one of the most serious complications after filtration surgery. There is no perfect way to stop the bleb leakage. Present study evaluated to close bleb leaks with a hydorogel sealant (FocalSeal®) in rabbits.
A fornix-based full-thickness filtration surgery with 24 gauge indwelling catheter and intraoperative mitomycin C was performed in each one eye of 6 New Zealand albino rabbits. After 1 week of the surgery, we perforated the bleb to make a 1.5 mm hole in the each filtration bleb. In three rabbits, the hole was covered using FocalSeal® with blue green light for 40 seconds. In the other three rabbits, we left the holes open. We checked the leakage with trypan blue. After 2 weeks of the first surgery, we checked the leakages of the six rabbits. After three weeks of the first surgery, the eyes were enucleated and examined histologically. In addition, we checked the intraocular pressures of both eyes with tonopen® for three weeks.
In the three rabbits with FocalSeal® application, the bleb leaking stopped after the treatment, although the others did not stop bleb leakage. The intraocular pressures of the eyes closed with FocalSeal® were always lower compared with those of the non-closed bleb leak group. On histological examinations, the holes were closed with covering of the conjunctival epithelial cell in FocalSeal® group, though the holes were open in the other group. By Masson's trichrome, PCNA and α-SMA immunohistochemical staining, the bleb holes closed with FocalSeal® accompanied less inflammatory cells than the just perforated holes did.
In this study, the bleb leaks could be functionally closed with FocalSeal®. The results suggest that the bleb leak closure with FocalSeal® can be an additional way of it in the filtration surgery of human glaucoma.
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