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Etienne Gardea, Denis Gruber, Berenice Coquerel, Sabine Lefevre, Alberto Della Martina, Raymond Andrieu, Marc Muraine; Polydioxanone Membrane As A Mitomycin-c Delivery System After Trabeculectomy In An Experimental Rabbit Model. Invest. Ophthalmol. Vis. Sci. 2011;52(14):644.
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Pharmacologic modulation of wound healing after glaucoma filtering surgery remains a major clinical challenge in ophthalmology. Polydioxanone is a biodegradable and biocompatible polymer use in human suture. The purpose of this study is to investigate effectiveness of polydioxanone (PDS) membrane as mitomycin-C (MMC) delivery system after trabeculectomy in rabbits by evaluating bleb appearance, intraocular pressure, and histological appearance of the subconjunctival (sc) area.
Ten New Zealand White rabbits (20 eyes) were assigned into 4 groups as follows: group 1 trabeculectomy alone (n= 4eyes); group 2 trabeculectomy with intraoperative MMC (0.2mg/mL, n=6); group 3 trabeculectomy with PDS mito(n=6) and group 4 trabeculectomy with PDS alone(n=4).Clinical exam and intraocular pressure (IOP) were evaluated over 7 and 15 days. Histological analyses were performed to evaluate and grade the amount of scarring and fibrosis in each group.
Mean IOP was respectively at 7 and 15 days : 8-11 mmHg in group 1; 5-11 mmHg in group 2; 5-5 mmHg in group 3 and 8-11 mmHg in group 4. There was significant difference between intraocular pressure in group 3 and the others groups (p<0.05). Clinically blebs were only present at day 15 in group 3, without local inflammation and fibrosis of the sc area. Histological analysis revealed that the eyes which received PDS-mito had significantly less postoperative scarring at the microscopic level at day 7 and 15.
Polydioxanone membrane seems to be an efficient drug delivery system because it is associated with improved trabeculectomy bleb survival for the rabbit model and lower IOP. PDS membrane with MMC may be a useful way to improve success by limiting scar tissue formation after trabeculectomy.
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