Cellular Photoablation to Control Postoperative Fibrosis in Filtration Surgery: in vitro Studies

Grisanti, Salvatore; Gralla, Artur; Maurer, Patrik; Diestelhorst, Michael; Krieglstein, Günter K.; Heimann, Klaus

doi:10.1006/exer.1999.0763

Cited by 17 publications

(9 citation statements)

References 36 publications

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“…The photoablative potential of BCECF-AM has been described previously15 and was confirmed for human Tenon fibroblasts in vitro 16…”

Section: Discussionmentioning

confidence: 88%

Comparative study between trabeculectomy with photodynamic therapy (BCECF-AM) and trabeculectomy with antimetabolite (MMC) in the treatment of primary open angle glaucoma

Saeed

2012

OPTH

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BackgroundVarious methods have been investigated to avoid postoperative scarring of the filtering bleb in modern glaucoma surgery. Most deal with the application of antimetabolic drugs such as mitomycin C (MMC). 2′,7′-bis-(2-carboxyethyl)-5-(and-6)-carboxyfluorescein, acetoxymethyl ester (BCECF-AM) is a locally acting intracellular photosensitizer which could control and decrease postoperative fibrosis at the trabeculectomy site.PurposeTo compare the effect of photodynamic therapy in combination with trabeculectomy to the effect of MMC combined with the same procedure in controlling postoperative intraocular pressure (IOP) in patients with medically uncontrolled primary open angle glaucoma (1ry OAG).MethodsA randomized controlled clinical trial was conducted on 76 eyes of 76 patients divided into three groups undergoing trabeculectomy, trabeculectomy with BCECF-AM (group A), trabeculectomy with MMC (group B), and trabeculectomy only as a control group (group C). Patients were reviewed postoperatively for clinical evaluation and photo documentation of the blebs with a fundus camera and ultrasonic biomicroscopy (UBM). The desirable effect of the adjunctive material was evaluated according to the clinical efficacy, tolerability, and safety by comparison with the control group.SettingBenha University Hospital, Benha, Egypt.ResultsAfter a mean follow-up of 24 months, all procedures succeeded in lowering IOP. The cumulative probability of complete success at the 24 month follow-up was 91% for group B, compared to 82% and 81.5% for group A and group C, respectively. The percentage of complete success was highest for group B, second highest for group A, and lowest for group C over the follow-up period; however, these differences were not statistically significant (P > 0.05). Regarding the bleb morphology and UBM reflectivity, the differences were not statistically significant (P > 0.05). The mean bleb height and breadth were larger in groups A and B in comparison to group C over the study period. The mean aqueous drainage route was similar in groups A and C, but less than in group B at 3 and 12 months postoperatively. Complications were generally mild and less marked in group A and C than group B.ConclusionCellular photoablation using BCECF-AM seems to be a feasible new method to use in combination with glaucoma filtration surgery. Although MMC might be considered a more potent adjunctive to trabeculectomy in promoting IOP reduction, photodynamic therapy carries relatively less risk of adverse effects and complications. Cellular photoablation using BCECF-AM could be considered efficient, tolerable and relatively safer in managing patients with 1ry OAG. Further studies are necessary to determine the safety and the reliability of this therapy.

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“…The photoablative potential of BCECF-AM has been described previously15 and was confirmed for human Tenon fibroblasts in vitro 16…”

Section: Discussionmentioning

confidence: 88%

Comparative study between trabeculectomy with photodynamic therapy (BCECF-AM) and trabeculectomy with antimetabolite (MMC) in the treatment of primary open angle glaucoma

Saeed

2012

OPTH

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“…The assay was carried out as previously described [14,23]. In brief, human Tenon's fibroblasts were grown to confluence on a slide.…”

Section: Proliferation Assaymentioning

confidence: 99%

Synergistic effects of combined cytotoxic and apoptosis-inducing drugs on Tenon’s capsule fibroblasts in vitro and in vivo

Mietz

Welsandt

Hueber

et al. 2007

Graefes Arch Clin Exp Ophthalmol

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“…Photodynamic therapy can cause regression of neovascularization and death of scleral and Tenon's fibroblasts in vitro (Grisanti et al 1999(Grisanti et al , 2000 and has shown promising results in the modulation of wound healing in glaucoma filtration surgery in both rabbits and humans (Smyth et al 1993;Grisanti et al 2000).…”

Section: Introductionmentioning

confidence: 99%

Photodynamic treatment in a rabbit model of glaucoma surgery

Stasi

Paccione

Bianchi

et al. 2006

Acta Ophthalmologica Scandinavica

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. Purpose: To evaluate the safety and efficacy of postoperative verteporfin photodynamic treatment as an adjunct to glaucoma experimental filtration surgery in rabbits. Methods: Dutch belted (n = 15) rabbits underwent full thickness sclerectomy in one eye. The experimental group (group 1, n = 7) underwent i.v. injection of verteporfin and subsequent photoactivation at the operative site on postoperative day 1 (POD 1). Control groups of animals received either light exposure (group 2, n = 4) or verteporfin (group 3, n = 2), or no intervention (group 4, n = 2). Intraocular pressure (IOP) was measured prior to the procedure (POD 0) and daily thereafter for the first week after sclerectomy (PODs 1−7) and every other day for the second week (PODs 9, 11, 13, 15). Percentage IOP reductions of operated over contralateral control eyes were compared among the various groups. Success rates (percentage IOP reduction > 15%) were also compared between the experimental and control groups. Eyes were histologically examined for evaluation of fibrosis. Results: Rabbits in the experimental group (group 1) had a mean ± SEM percentage IOP reduction of 25 ± 3% during the follow‐up period. In contrast, groups 2, 3 and 4 had IOP reductions of 4 ± 5%, 12 ± 7% and 4 ± 6%, respectively (p < 0.005, anova among all four groups). Successful IOP reduction (≥ 15%) over the contralateral eye at POD 15 was achieved in six of seven experimental animals, but only in one of eight control animals (p < 0.02, chi‐squared test). Bleb failure occurred significantly earlier in the control eyes compared with eyes receiving PDT (p < 0.003, log rank test). Blebs in the experimental group differed from those in the control groups histologically, lacking significant collagen deposition in the area of the sclerostomy. Conclusions: Wound healing in glaucoma surgery may be successfully modulated postoperatively using photodynamic therapy with i.v. administered photosensitizer.

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Cellular Photoablation to Control Postoperative Fibrosis in Filtration Surgery: in vitro Studies

Cited by 17 publications

References 36 publications

Comparative study between trabeculectomy with photodynamic therapy (BCECF-AM) and trabeculectomy with antimetabolite (MMC) in the treatment of primary open angle glaucoma

Comparative study between trabeculectomy with photodynamic therapy (BCECF-AM) and trabeculectomy with antimetabolite (MMC) in the treatment of primary open angle glaucoma

Synergistic effects of combined cytotoxic and apoptosis-inducing drugs on Tenon’s capsule fibroblasts in vitro and in vivo

Photodynamic treatment in a rabbit model of glaucoma surgery

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