J Korean Ophthalmol Soc.  2010 May;51(5):740-745.

Glaucoma Filtering Surgery With Low Concentration of Cyclosporin A in Rabbits: A Pilot Study

• Kim YD
• Hwang HB
• Park MH
• Moon JI

Abstract

PURPOSE
The effect of 0.2% cyclosporin A (CsA) as an adjuvant therapy after glaucoma-filtering surgery was the focus of this study.
METHODS
A posterior lip sclerotomy was performed in 16 eyes of 8 rabbits, and 0.2% CsA was administered into the right eyes. The left eyes served as controls. The intraocular pressure (IOP) was measured 1, 3, 5, 7, 14, and 28 days after surgery. Hematoxylin-eosin (HE) and anti-bromodeoxyuridine (BrdU) immunocytochemical staining were performed at 1, 2, 4, and 8 weeks.
RESULTS
The IOP at 7 and 14 days after surgery was lower in the 0.2% CsA group and statistically significant (P=0.047, P=0.48; respectively). HE staining did not show any difference between experimental and control eyes, but anti-BrdU staining showed a lower number of positive cells in the experimental eyes at 1 week. The fibroblast proliferation rate was significantly lower 1 week after surgery in the 0.2% CsA group (P=0.003).
CONCLUSIONS
An effect of 0.2% CsA on early wound healing was observed. The data suggest that a low concentration of CsA can be useful when employed as adjuvant therapy in glaucoma filtering surgery.

Keyword

Adjuvant therapy; Antifibrotic agent; Cyclosporin; Glaucoma filtering surgery; Wound healing

MeSH Terms

Cyclosporine
Eye
Fibroblasts
Filtering Surgery
Glaucoma
Intraocular Pressure
Lip
Pilot Projects
Rabbits
Wound Healing
Cyclosporine

Figure

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  Figure 1. Glaucoma filtering surgery in a rabbit eye. A fornix-based conjunctival incision was undertaken in the upper-nasal part of the eye (between superior rectus muscle and medial rectus muscle). The anterior chamber was then entered through the filtering site, and a 3×1 mm block of scleral tissue and trabecular meshwork was excised. Peripheral iridectomy was not performed.

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  Figure 2. High magnification photographs of immunocytochemically stained sections (×400). The right photographs are eyes instilled with 0.2% CsA (A). The left photographs are control eyes (B). Many bromodeoxyuridine (BrdU)-positive cells (red arrow) are shown 1 week after surgery (A and B). Fewer BrdU-positive cells existed in experimental eyes (A). The scale bars indicate 50 μm.

Reference

References

1. Lu DW, Chang CJ, Chiang CH, et al. Wound modulation after abdominal by different formulations of antimetabolites in rabbits. J Ocul Pharmacol Ther. 2000; 16:529–38.

2. Nuzzi R, Cerruti A, Finazzo C. Cyclosporine C: a study of wound-healing modulation after trabeculectomy in rabbit. Acta Ophthalmol Scand Suppl. 1998; 227:48–9.

3. Turaçli ME, Gündüz K, Aktan G, Sencer H. Topical cyclosporine as a possible new antimetabolite in trabeculectomy. Ophthalmic Surg Lasers. 1996; 27:438–44.

4. Broadway DC, Chang LP. Trabeculectomy, risk factors for failure and the preoperative state of the conjunctiva. J Glaucoma. 2001; 10:237–49.

5. Baek YW, Moon JI, Park CK. Effects of Taxol and Mitomycin C on Morphologic Alteration of Cultured Rabbit Subconjunctival Fibroblasts. J Korea Ophthalmol Soc. 2003; 44:202–7.

6. Shouman AA, Helal A, Marzouk MA, Zaki EM. Methylcellulose, a healing inhibitor factor in an animal model of trabeculectomy. Invest Ophthalmol Vis Sci. 2006; 47:2515–9.

7. Lama PJ, Fechtner RD. Antifibrotics and wound healing in glaucoma surgery. Surv Ophthalmol. 2003; 48:314–46.

8. Park KH, Kim DM. The Effects of Topical Cyclosporin A on Glaucoma Drainage Implant Surgery in Rabbits. J Korean Ophthalmol Soc. 1995; 36:307–15.

9. Garweg JG, Wegmann-Burns M, Goldblum D. Effects of abdominal, mitomycin C, azathioprine and cyclosporin A on human retinal pigmented epithelial, corneal endothelial and conjunctival cell lines. Graefes Arch Clin Exp Ophthalmol. 2006; 244:382–9.

10. Bagci G, Yucel I, Duranoglu Y. The effect of cyclosporin A on abdominal rabbit subconjunctival fibroblast proliferation. Ophthalmologica. 1999; 213:114–9.

11. Cristofanilli M, Pescosolido N, Risuleo G, Scarsella G. A murine cell culture model for post-trabeculectomy anfibrotic treatment: Induction of apoptosis by Cyclosporin. Acta Ophthalmol Scand. 2001; 79:309–12.

11. Akafo SK, Goulstine DB, Rosenthal AR. abdominal post abdominal intraocular pressures. Acta Ophthalmol (Copenh). 1992; 70:312–6.

12. Mills KB. Trabeculectomy: a retrospective long-term follow-up of 444 cases. Br J Ophthalmol. 1981; 65:790–5.

13. Zaidi AA. Trabeculectomy: a review and 4-year follow-up. Br J Ophthalmol. 1980; 64:436–9.

14. Jerndal T, Lundstrom M: 330 trabeculectomies. A long time study (3–5 1/2 years). Acta Ophthalmol (Copenh). 1980; 58:947–56.

15. Ahn JE, Lee YG, Hong YJ. abdominal Follow-up after Trabeculectomy with Mitomycin c. J Korea Ophthalmol Soc. 1998; 39:993–1001.

16. Watson PG, Jakeman C, Ozturk M, et al. The complications of abdominal (a 20-year follow-up). Eye. 1990; 4:425–38.

17. Lattanzio FA Jr, Crouch ER Jr, Mitrev PV, et al. Cyclosporin as an abdominal to glaucoma filtration surgery. J Glaucoma. 2005; 14:441–7.

18. Seetner A, Morin JD. Healing of trabeculectomies in rabbits. Can J Ophthalmol. 1979; 14:121–5.

19. Miller MH, Joseph NH, Ennis KW, et al. An animal model of filtration surgery. Trans Ophthalmol Soc U K. 1985; 104:893–7.

20. Jampel HD, McGuigan LJ, Dunkelberger GR, et al. Cellular abdominal after experimental glaucoma filtering surgery. Arch Ophthalmol. 1988; 106:89–94.