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Alastair Lockwood, Abeer Mohamed Ahmed, Ashkan Khalili, Sahar Awwad, Garima Sharma, Athmar Dhahir Habeeb, Hanieh Khalili, Steve Brocchini, Peng Khaw; An ethylcellulose spacer is similar to mitomycin C in prolonging bleb survival in an experimental animal model. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3202. doi: https://doi.org/.
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The application of an inert spacer is a potential non-toxic alternative to mitomycin C (MMC) for prolonging bleb survival in glaucoma surgery, and the principal by which drainage devices succeed. The aim of this experiment was to compare bleb survival using a small diameter implant with MMC.
A randomised, prospective, masked, single observer in vivo study over 30 days. Glaucoma filtration surgery was performed on 14 New Zealand White rabbits. The rabbits received perioperatively one of two potential subconjunctival treatments, randomised according to a Latin Square design: MMC solution (0.2 mg for 3 minutes) or ethylcellulose tablet 2 mm diameter X 0.4 mm high (1 mg). Success was determined according to bleb survival.
Of the MMC treated group, 29% (2) had successful blebs at day 30, and of the ethylcellulose treated group 43 % (3) had successful blebs at day 30. The differences in bleb survival between the ethylcellulose tablets and MMC were not statistically significant (log rank P = 0.57).
An inert implant appears to promote bleb survival to a similar extent to MMC in this animal model using masked observer standard measurements of failure. The spacer effect may have an important effect in this model and this may also be clinically relevant in the development of new therapies and devices for glaucoma surgery.
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