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Zhaoxing Dai, Xinghuai Sun; Grooved glaucoma drainage devices that continuously deliver cyclosporine A decrease postsurgical scar formation in rabbit eyes. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5578.
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© ARVO (1962-2015); The Authors (2016-present)
To improve the potential for glaucoma drainage devices (GDDs) based on redesigning our previously used GDDs. The preventative effects of the GDDs were examined in an experimental rabbit model.
Our novel GDDs were prepared by molding liquid medical silicon. The GDDs were designed to contain grooves, which were left uncoated or coated with a laye for continuous CsA delivery. Thus, two experimental GDDs were prepared: uncoated grooved GDDs (G-GDDs) and CSA-PLGA-coated G-GDDs. Eighteen eyes in nine New Zealand rabbits were randomly divided into three groups (six eyes per group). The intraocular pressure (IOP), BST, bleb morphology, and anterior chamber (AC) reactions were assessed. Bleb morphology was quantified using the Indiana Bleb Appearance Grading Scale. AC radiography was performed to check whether the filtrating pathway was blocked. H-E staining and immunohistochemistry were conducted to assess how the GDDs slowed or prevented scar formation.
The novel GDDs were successfully manufactured and all 18 eyes underwent GDD implantation without severe surgical complications. BST was significantly longer and IOP was significantly lower in both G-GDD groups(all, P < 0.001). Bleb morphology improved significantly in the CsA-G-GDD group (P = 0.003 for height). AC radiography revealed significant improvement in contrast agent diffusion in the CsA-G-GDD group (P = 0.032). Significant histological differences were found, which indicate that CsA-PLGA and the presence of grooves on the GDD influenced postsurgical scar formation.
Implantation of G-GDDs improved the prognosis of glaucoma surgery . The prognosis was improved further by implanting G-GDDs coated with a CsA-PLGA layer.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
(a) - (c) show the morphology of a single eye in each group over time. The black arrowheads show the range of blebs. Bleb morphology was assessed according to the IBAGS classification. (d) Bleb height. (e) Bleb edge. (f) Bleb vascularization.
(a) - (c) Anterior chamber radiography. Images are shown when fluorescein diffused to the maximum area. The red arrowheads show the range of the blebs and the blue arrows show the drainage tube.(d) - (f) Histology of the surgical area. Blue dashed lines indicate the scar tissue around the implanted GDD and the blue arrows indicate the thickest part of the scar layer. The black arrows indicate blebs that were separated.
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