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Michael E. Jansen, Dan Good, Sohrab Sidhu, Jon Kaufman, Thomas Mosley, Ted W. Reid; Testing of a Selenium (Se) Coated Biomaterial for Use in Glaucoma Surgery. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3742.
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Glaucoma is a major medical problem causing blindness and chronic vision impairment for countless patients throughout the world. Intraocular pressure (IOP), the most important glaucoma risk factor, can be predictably manipulated surgically.Surgical options are effective at lowering IOP and minimize glaucoma progression. Trabeculectomy (preferred invasive procedure) allows aqueous to exit the eye and be absorbed in the subconjunctival & retrobulbar space. There is a significant risk of failure due to postoperative inflammation that leads to fibrosis. Mitomycin C & 5-Fluorouracil, the current standard of care for trabeculectomy surgery, modulate wound healing, increasing the long-term success of the surgery however, adverse side effects of these drugs temper their use as an adjuvant.Se has (1) antimicrobial properties and (2) may minimize fibrosis without any adverse biological effects. Selenium has the ability to catalyze the formation of superoxide radicals. Thus, covalently attached selenium may inhibit fibrosis after glaucoma surgery. The present study was carried out to determine whether selenium can be covalently attached to a medical device and inserted into the eye with no harmful effects upon the surrounding tissue.
Trabeculectomy filtering surgery was performed on 28 rabbit eyes. These eyes were divided into 4 groups, each receiving different concentrations of selenium attached to a biomaterial matrix. [7 eyes - no Se (control), 7 eyes 0.1% Se, 7 eyes 0.5% Se & 7 eyes using 1.0% Se]. The eyes were examined pre-operatively and followed for 90 days post-operatively to measure and record intraocular pressure, corneal clouding, anterior chamber inflammation, cataract formation, and the height, extent, and vascularity of the bleb created surgically.
Results from the post-operative measurements of the 28 eyes used in the study show no large differences amongst groups for the following parameters: IOP’s, corneal clouding, anterior chamber inflammation, cataract formation, and bleb characteristics.
Results from the 28 rabbits suggest that selenium is a safe agent for use in trabeculectomy filtering surgery. The use of Se did not produce or increase the occurrence of elevated IOP’s, corneal clouding, anterior chamber inflammation, or cataract formation. These results indicate that Se does not produce adverse effects that would detrimentally effect trabeculectomy surgery and the use and efficacy of Se can be safely explored in glaucoma filtering surgery procedures.Further research and data analysis should result in a new biomaterial technology which can modulate fibrosis after a glaucoma filtering operation and maintain an open filter with minimal side effects to the ocular tissue.
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