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Marcus Ang, Peng Yan, Ma Zhen, Selin Foo, Wing Sum Lee, Subbu S. Venkatraman, Tina T. Wong; Prednisolone Acetate Loaded Biodegradable Microfilm Attenuates The Post-operative Inflammatory Response Following Experimental Glaucoma Filtration Surgery. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3221.
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To evaluate the efficacy of a biodegradable microfilm providing sustained release of prednisolone acetate on modulating post-operative inflammation and improving bleb survival after experimental glaucoma filtration surgery.
We fabricated biodegrable microfilms composed of poly (d, l-lactide-co-caprolactone) (PLC) 70/30 which were pre-loaded with 20% total weight of prednisolone actetate. We randomised 14 female New Zealand White rabbits into 3 treatment groups: filtration surgery alone (n=4), filtration surgery with PLC microfilms (n=4) and filtration surgery with prednisolone acetate loaded PLC microfilm (n=6). Microfilms were inserted in the subconjunctival pocket adjacent to the site of filtration. We clinically monitored the rabbits with slit-lamp microscopy; bleb photography and anterior segment optical coherence tomography (ASOCT). Animals were sacrificed after 28 days and histology performed to identify any signs of inflammation or subconjunctival scarring.
Our in vivo study results revealed a steady, linear, sustained release of prednisolone acetate from the 20% prednisolone-loaded microfilms. Eyes implanted with prednisolone-loaded PLC microfilms demonstrated significantly better bleb survival and reduced bleb conjunctival vascularity, as compared to the other two treatment groups. All eyes implanted with prednisolone-loaded microfilms (n=6) had blebs that survived at 30 days, while control eyes with no microfilms (n=4) and control eyes with blank microfilms (n=4) had all failed by median 17.5 (range, 14 -21) days. On ASOCT, significant blebs were visible in all eyes (6 eyes) with prednisolone-loaded microfilms as compared to the other treatment groups, where only 3/8 eyes (37.5%) had visible blebs (P<0.001). Our observations were supported by the presence of significantly less subconjunctival inflammation and scarring around the filtration site in the prednisolone-loaded PLC microfilm treated group on histology.
Sustained release of prednisolone acetate from biodegradable microfilms can successfully reduce the post-surgical inflammatory response and thereby prolong bleb survival in this rabbit surgical model.
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