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H. H. Russ, F. Montiani-Ferreira, J. H. Truppel, P. Muzolon, C. Pinto, F. E. Carvalho, D. Sakamoto; Comparison of Inflammatory Reaction of Topical Cyclosporine, Prednisolone Acetate1% and Association of Cyclosporine/prednisolone in the Post-Op of Trabeculectomy in Prostamide Previously Treated Rabbits: Histology, Histomorphometry and Imunohistoquemistry. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4159.
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To compare the best post-trabeculectomy (TREC) drug protocol.
30 rabbits were split in 3 groups (G1, G2 and G3). Prostamide was instilled topically daily for 10 days in all right rabbit eyes. After, the G1, G2 and G3 rabbits underwent a TREC. In the post-operative phase, all rabbits received topically 0.3% gatifloxacin 4 times a day. Rabbits from G1 received 1.0% prednisolone acetate 4 times a day; G2 0.05% cyclosporine 2 times a day and G3 received the association of prednisolone acetate 4 times a day and cyclosporine 2 a day. Seven days after the surgery all rabbits were euthanized. Histomorphometry was performed using HE and PAS stained sections and analyses were made with Image Pro-Plus 4.5 software. Inflammatory infiltrate, epithelial thickness, number of goblet cells, area and number of blood vessels were evaluated. Imunohistochemistry staining using AC Smooth Muscle Anti-Actin, Anti-Factor VIII and Anti-IL-6 was performed. One-way ANOVA with a significance level of 5% followed by Tukey-Kramer post hoc tests were used.
G1 showed an increase in epithelial thickness (P=0.03), with the mean value of G1, G2 and G3 being 29.3 ± 10.27 µm ; 25.1 ± 5,161 µm and 24,4 ± 3,812, respectively. Vascular diameters were significantly increased in G1 (30.3 ± 11.28 µm) and G2 (27.7 ± 10.90 µm) (P=0.0011 and P<0.0001, respectively) in relationship to G3 values (19.8 ± 6.9 µm). G1 showed a higher vascular area when compared to G2 and G3 (P=0.015 and P=0.003, respectively). There were IL-6 reaction in all groups, but G3 showed less stainning for Anti-Actin Smooth Muscle and Anti-Factor-VIII. Discussion and
The vascular area was significantly was smaller in the cyclosporine group. Inflammatory infiltrate was less intense in the group treated with the 1% prednisolone acetate in comparison to 0.05% cyclosporine, but significantly less intense than the group treated with the association of drugs. This study suggests the association of prednisolone and cyclosporine seems to be more efficient in controlling inflammatory reaction than the others in the post-operatory of trabeculectomy in rabbits.
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