Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
PLoS One. 2021 May 28;16(5):e0252467. doi: 10.1371/journal.pone.0252467. eCollection 2021.
Wound healing after Ahmed glaucoma valve (AGV) implantation often entails fibrosis as a foreign body reaction to the silicone plate. Poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) forms an antifouling surface that inhibits fibrosis during wound healing. In this study, we aimed to compare the effects of the implantation of AGV coated with PMPC (wPMPC) versus AGV without PMPC (woPMPC) in rabbits.
Six New Zealand White rabbit does underwent AGV implantation in both eyes. For each rabbit, one eye was randomly selected for implantation of AGV wPMPC and a conventional AGV (woPMPC) was implanted in the contralateral eye. Gross conjunctival vascularity was compared between the two groups at the first, second, and fourth weeks after surgery. The eyes were enucleated in four weeks and subjected to staining with hematoxylin and eosin and Masson's trichrome stain. The fibrosis and inflammation status among the eye samples were compared by measuring the thickness of the fibrotic walls and counting the number of chronic inflammatory cells around the AGV. Counting of inflammatory cells and measuring fibrotic wall thickness were done in a blinded method to eliminate observer bias. Statistical analysis was performed using the Mann-Whitney U test.
Gross and histological examinations revealed no toxic effects of PMPC. There were no apparent differences in overall conjunctival vascularity between the two groups at weeks 1, 2, and 4 after surgery. The average inflammatory cell counts were 14.3 ± 5.8 per slide and 27.3 ± 8.6 per slide in the wPMPC and woPMPC groups, respectively (p = 0.037). The average thicknesses of the fibrotic wall were 57.9 ± 11.3 μm and 81.5 ± 21.3 μm in the wPMPC and woPMPC groups, respectively (p = 0.025).
Compared to the woPMPC group, the number of inflammatory cells and fibrosis were significantly decreased in the wPMPC group.
Ahmed 青光眼引流阀（AGV）植入后，常因硅胶板引起异物反应而导致纤维化。聚（2-甲基丙烯酰氧乙基磷酰胆碱）（PMPC）形成抗污表面，可抑制伤口愈合过程中的纤维化。本研究旨在比较在新西兰白兔中植入涂有 PMPC（wPMPC）的 AGV 与未涂 PMPC（woPMPC）的 AGV 的效果。
6 只新西兰白兔母兔双眼均植入 AGV。每只兔子的一只眼随机选择植入 wPMPC 的 AGV，另一只眼植入常规 AGV（woPMPC）。术后第 1、2、4 周比较两组的结膜总体血管化情况。4 周时眼球摘出，行苏木精和伊红及 Masson 三色染色。通过测量纤维性壁的厚度和计算围绕 AGV 的慢性炎症细胞数量，比较眼样本的纤维化和炎症状态。炎症细胞计数和纤维性壁厚度的测量采用盲法进行，以消除观察者偏倚。采用 Mann-Whitney U 检验进行统计学分析。
PMPC 无毒性作用。术后 1、2、4 周，两组总体结膜血管化无明显差异。wPMPC 组和 woPMPC 组的平均炎症细胞计数分别为 14.3 ± 5.8 个/视野和 27.3 ± 8.6 个/视野（p = 0.037）。wPMPC 组和 woPMPC 组纤维性壁的平均厚度分别为 57.9 ± 11.3 μm 和 81.5 ± 21.3 μm（p = 0.025）。
与 woPMPC 组相比，wPMPC 组的炎症细胞和纤维化数量明显减少。
