Effects of Amniotic Membrane Transplantation and Mitomycin C on Wound Healing in Experimental Glaucoma Surgery

Abstract

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.

A Thin Honeycomb-patterned Film as an Adhesion Barrier in an Animal Model of Glaucoma Filtration Surgery

“…25 Amniotic membrane transplantation, which showed suppression of wound healing in experimental filtration surgery in agreement with its ability to down regulate TGFß signaling, 26 may also have a space-keeping effect as a mechanical barrier.…”

“…[8][9][10][11][12][13] Recently, to avoid such postoperative complications caused by MMC and 5-FU, various anti-scarring chemicals and mechanical adhesion barriers have been used in glaucoma filtration surgery in animal models. [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] Although favorable results were reported, no alternative methods to MMC or 5-FU treatment have been widely adapted until now.…”

Update on Modulating Wound Healing in Trabeculectomy

“…They have shown that transplantation of a single (Fujishima et al, 1998;Lu and Mai, 2003;Yue et al, 2003;Drolsum et al, 2006) or folded (Bruno et al, 2006;Eliezer et al, 2006) sheet of AM under the scleral flap (Fujishima et al, 1998;Yue et al, 2003;Drolsum et al, 2006;Bruno et al, 2006), and/or under the conjunctiva (Yue et al, 2003;Drolsum et al, 2006;Bruno et al, 2006;Eliezer et al, 2006), with additional MMC (Fujishima et al, 1998;Drolsum et al, 2006;Bruno et al, 2006), reduces IOP in eyes with refractory glaucoma. Experimental rabbit studies demonstrated that the AM, inserted under the scleral flap, achieves the same reduction of subconjunctival fibroblasts and macrophages around the trabeculectomy sites as that achieved by MMC (Demir et al, 2002;Wang et al, 2005), as well as reduces the number of fibroblasts at trabeculectomy sites when inserted under the scleral flap even without MMC (Zhong et al, 2000;Barton et al, 2001). …”

Post-trabeculectomy topical bevacizumab preventing bleb failure: a preliminary study

“…Besides these, β-radiation, amniotic membrane, and even photodynamic therapy have been used for the success of trabeculectomy [19][20][21][22][23].…”