Abstract
Purpose::
To evaluate the effectiveness and safety of a honeycomb-patterned film (Teijin Ltd, Osaka, Japan), an about 7µm thick bioresorbable poly(L-lactide-co-epsilon-caprolactone) film that has a honeycomb structure on one side (adhesive side) and a plane structure on another side (adhesion preventing side), on glaucoma filtration surgery in rabbits.
Methods::
Trabeculectomy was performed on both eyes of all white rabbits. In all groups, one eye was received trabeculectomy with a honeycomb-patterned film. Following groups were classified by adjunctive treatments in another eye: no adjunctive treatments (group1, control, n=6); mitomycin C (MMC) (group2, n=6); Seprafilm® (group3, n=6). Surgical procedures consisted of limbal based conjunctival incision, 3×3mm partial-thickness scleral flap preparation, trabeculectomy, scleral flap excision, and conjunctival closure (control eye). In honeycomb-patterned film-treated eyes, a 6×6mm honeycomb-patterned film, turned honeycomb side toward tenon tissue, was sutured on the sclera at the three points after scleral flap excition. Seprafilm® was placed on the sclera without suture. In MMC-treated eye, 0.4 mg/ml MMC was applied on the sclera under the conjunctival flap for 3 minutes. IOP measurement and postoperative bleb appearance evaluated using Ultrasound biomicroscopy (UBM) were recorded over time for 28 days after surgery.
Results::
Two eyes treated with MMC and one eye treated with Seprafilm® had transconjuctival aqueous oozing in the bleb. In five control eyes and two honeycomb-patterned film-treated eyes in group 1, one MMC-treated eye in group 2 and one Seprafilm®-treated eye in group 3, filtering blebs failed. Blebs did not fail in honeycomb-patterned film-treated eyes in group 2 and 3. In group 1, the bleb survival time of honeycomb-patterned film-treated eyes (25.5±4.5 days) was significantly longer than that of the control eyes (11.5±11.2 days) (P<0.05). In group 2 and 3, the bleb survival time between fellow eyes was not significantly different. Histologically, a honeycomb-patterned film was observed in 78% of all honeycomb-patterned film-treated eyes 28 days after surgery.
Conclusions::
The results of current study suggest that the use of a honeycomb-patterned film on glaucoma filtration surgery prolongs the survival of filtering bleb.
Keywords: wound healing • sclera • conjunctiva