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T. Okuda, T. Higashide, Y. Fukuhira, Y. Sumi, K. Sugiyama; The Effectiveness of a Honeycomb-Patterned Film as Membrane Adhesion Barriers in Animal Model of Glaucoma Filtration Surgery. Invest. Ophthalmol. Vis. Sci. 2007;48(13):825.
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© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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.
The results of current study suggest that the use of a honeycomb-patterned film on glaucoma filtration surgery prolongs the survival of filtering bleb.
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