SooHoo Jeffrey R, Seibold Leonard K, Laing Ashley E, Kahook Malik Y
Department of Ophthalmology, University of Colorado Denver, Aurora, CO 80045, USA.
Mol Vis. 2012;18:714-9. Epub 2012 Mar 26.
To determine the effect of a sustained-release dexamethasone implant (Ozurdex(®)) on wound healing after glaucoma filtration surgery in a rabbit model.
Twelve new zealand white rabbits were divided into three groups: filtration surgery with intraoperative subconjunctival implantation of Ozurdex(®) (n=6), filtration surgery with intraoperative topical application of mitomycin-C (MMC; n=6), and filtration surgery with intraoperative topical application of balanced salt solution (BSS; n=12). A standard scale was used to grade bleb vascularity at three and six weeks after the initial operation. Bleb survival was also recorded for comparison between the three groups. Histologic analysis was performed with attention to cellularity and collagen deposition.
MMC-treated blebs demonstrated decreased numbers of goblet cells compared to all other groups. Blebs treated with Ozurdex(®) maintained a near normal number of goblet cells with modest collagen deposition. The control eyes treated with only BSS had significant collagen deposition and increased cellularity compared to both the Ozurdex(®) and MMC groups. Bleb vascularity was not significantly different among groups at the three and six week post-operative evaluations. MMC-treated and Ozurdex(®)-treated blebs had significantly prolonged bleb survival compared to blebs treated with only BSS. In addition, MMC-treated blebs had significantly longer survival compared to Ozurdex(®)-treated blebs.
The results of this study support the utility of extended-release dexamethasone (Ozurdex(®)) as a wound modulating agent in a rabbit model of filtration surgery. Further animal and human studies are needed to better characterize a possible role for Ozurdex(®) in filtration surgery.
在兔模型中确定缓释地塞米松植入物（Ozurdex®）对青光眼滤过术后伤口愈合的影响。
将12只新西兰白兔分为三组：术中结膜下植入Ozurdex®的滤过手术组（n = 6）、术中局部应用丝裂霉素C（MMC）的滤过手术组（n = 6）和术中局部应用平衡盐溶液（BSS）的滤过手术组（n = 12）。使用标准量表在初次手术后3周和6周对滤过泡血管化程度进行分级。还记录滤过泡存活情况以比较三组之间的差异。进行组织学分析，重点关注细胞成分和胶原沉积情况。
与所有其他组相比，MMC处理的滤过泡杯状细胞数量减少。用Ozurdex®处理的滤过泡杯状细胞数量接近正常，胶原沉积适度。仅用BSS处理的对照眼与Ozurdex®组和MMC组相比，胶原沉积显著增加且细胞成分增多。在术后3周和6周的评估中，各组之间滤过泡血管化程度无显著差异。与仅用BSS处理的滤过泡相比，MMC处理和Ozurdex®处理的滤过泡存活时间显著延长。此外，MMC处理的滤过泡存活时间比Ozurdex®处理的滤过泡显著更长。
本研究结果支持在滤过手术兔模型中，缓释地塞米松（Ozurdex®）作为伤口调节剂的效用。需要进一步的动物和人体研究，以更好地明确Ozurdex®在滤过手术中可能发挥的作用。
