Purpose: To evaluate the effects of mitomycin C and amniotic membrane transplantation on the modulation of wound healing after glaucoma filtration surgery. Methods: Trabeculectomy was performed in 3 groups of 10 rabbit eyes each. Sponges soaked in mitomycin C were applied to the first group, and amniotic membranes were transplanted around the scleral flap in the second group; the third group was the control. The arithmetic means of fibroblast and macrophage numbers per square centimetre were calculated. Results: The mean numbers of fibroblasts and macrophages were decreased significantly in the mitomycin C group, compared with the controls (p < 0.0001). Cell counts in the amniotic membrane group were also lower than the ones in the control group for fibroblasts and macrophages (p < 0.0001, p < 0.01, respectively). The difference between the two treatment groups was statistically significant for fibroblasts (p < 0.0001), but not significant for macrophages (p > 0.05). Conclusion: In spite of the fact that amniotic membrane transplantation is less effective than mitomycin C for depressing wound healing after trabeculectomy, it might be a safer alternative in selected cases when considering severe adverse effects of antimetabolites.

Background:The successful lowering of the intraocular pressure after glaucoma filtration surgery depends mostly on the nature of the healing response, which is also the single most important modifiable factor.Aims:To evaluate and compare the effectiveness of two oxidated regenerated cellulose material, Interceed and Surgicel on wound healing reaction after glaucoma filtration surgery.Setting and Design:University hospital, prospective study.Materials and Methods:Full thickness filtration surgery was carried out on three groups of rabbits. Interceed and Surgicel was applied in Groups 1 and 2 respectively. The third group was the controls. Intraocular pressure, anterior chamber depth and bleb appearance were checked on the first, third, seventh and 14th days. The rabbits were sacrificed on the14th day and the trabeculectomy area with overlying conjunctiva was excised, fixed, stained and evaluated histopathologically.Statistics:The values obtained from the clinical and histopathologic evaluation were statistically analyzed using non-parametric tests (Mann Whitney-U and Kruskall Wallis tests) in SPSS for Windows v-10. P values under 0.05 for statistical significance in comparisons were considered significant.ResultsThe groups were similar with respect to intraocular pressure, anterior chamber depth, bleb appearance and number of the fibroblasts and neutrophils on the seventh and 14th days. Mean number of the eosinophils and vessels was significantly less in Groups 1 and 2 (P = 0.014, P = 0.20 respectively). Macrophages in Group 2 were significantly less than Group 1 (P = 0.047).ConclusionBoth these agents seem to suppress vascularization. Since they have no significant effect on fibroblast proliferation, it is controversial to talk about wound healing modulation.

Octreotide acetate and cyclosporin A are less toxic alternatives to mitomycin C and 5-fluorouracil in glaucoma filtration surgery.

Neither of these two adhesion-preventing substances seems to suppress wound healing reaction after glaucoma filtration surgery. However, a diminished wound healing reaction was expected wi th a decreased number of vessels, such as in Group 1. Increased number of macrophages in both groups may result in a decreased level of some inflammatory mediators.

Octreotide reduced wound-healing reaction in a similar fashion to corticosteroids or mitomycine-C. These initial results seem promising.