Application of Seprafilm® for Preventing Postoperative Adhesion in Glaucoma Surgery

Abstract

Abstract: : Purpose: To investigate the effect of Seprafilm® (Genzyme Corporation.), which is an anti–adhesion sheet used in abdominal and pelvic surgeries, in preventing postoperative conjunctiva–sclera adhesion in glaucoma surgery. Methods: Fourteen eyes of 14 rabbits and 38 eyes of 38 rats were involved in this study. All experiments were carried out in the right eye under general anesthesia. A pocket was made between conjunctiva and sclera through a conjunctival incision at 1mm posterior from corneal limbus. A 5×4mm of Seprafilm® was inserted into this pocket in 7 rabbits and a 3×2mm of Seprafilm® in 19 rats, then conjunctival wound was tucked with 10–0 nylon sutures. The conjunctival pocket was closed without Seprafilm® in other rabbits and rats as the control. Four weeks after the surgery, the pressure for detaching conjunctiva and sclera by compressing air through 27G needle inserted underneath conjunctiva was measured with a sphygmomanometer in all eyes of rabbits. In all rats, eyes were enucleated 4 weeks after the surgery for histological evaluation of postoperative adhesion. Results: The mean detaching pressure was 155.7±78.2 mmHg in eyes with Seprafilm® and 255.7±70.5 mmHg in control eyes. The pressure in eyes with Seprafilm® was significantly lower than that of control eyes. The postoperative adhesion was less prominent histologicaly in rats' eyes with Seprafilm® than those without it. Conclusions: The results indicate that Seprafilm® can prevent postoperative conjunctiva–sclera adhesion. It warrants further study for clinical application of Seprafilm® in filtering surgery for glaucoma such as trabeculectomy.

Keywords: wound healing • conjunctiva • sclera