Ophthalmology Department, Unidade Local de Saúde Médio Tejo, Tomar, Portugal.
Int Ophthalmol. 2024 Jul 22;44(1):332. doi: 10.1007/s10792-024-03253-z.
Plasma rich in growth factors (PRGF) technology creates blood-derived products with growth factors that promote wound healing and regeneration. The goal of this study was to assess the potential role of PRGF products as wound modulators in trabeculectomy. Our premise is that due to PRGF's regenerative and antifibrotic properties, its use in trabeculectomy may produce a more physiological bleb, without altering IOP reduction.
A retrospective, longitudinal study was conducted in a Hospital in Portugal. Patients with eyes with open angle glaucoma were included. Trabeculectomy was performed on all patients using PRGF membrane (mPRGF) under the conjunctiva, as adjuvant. Data regarding patients' demographics and number of medications used, was collected. Intraocular pressure (IOP) before surgery, 8 days, 1 month, 3 month, 6 month, 9 month and 1 year after surgery was recorded. Bleb morphology was classified according to Moorfields Bleb Grading System 6 months after surgery.
Nine eyes of 9 patients were enrolled. Mean age was 71 ± 5.1 years old. Six were male. Mean IOP decreased from 24.0 ± 8.8 mmHg pre-surgery to 12.9 ± 2.6 mmHg at one year follow-up. The number of hypotensive drugs (mean ± SD) was 4.3 ± 0.9 preoperatively and 0.8 ± 1.1 at 1-year. Complete success was defined as IOP equal to or less than 21 mm Hg without ocular hypotensive medications and qualified success as IOP equal to or less than 21 mm Hg with medications. Complete success was 66.7% and qualified success was 100% at 1 year follow-up.
In our study, trabeculectomy with mPRGF demonstrated both safety and efficacy. Low values of bleb height (1.6 ± 0.8) were recorded. mPRGF could improve wound healing and produce a more well-tolerated, favourable bleb, avoiding antimetabolite complications.
富含生长因子的血浆（PRGF）技术可生成富含生长因子的血液衍生产品，促进伤口愈合和再生。本研究的目的是评估 PRGF 产品作为小梁切除术的伤口调节剂的潜在作用。我们的前提是，由于 PRGF 的再生和抗纤维化特性，其在小梁切除术中的使用可能会产生更生理性的滤过泡，而不会改变眼压降低。
这是葡萄牙一家医院进行的回顾性、纵向研究。纳入患有开角型青光眼的患者。所有患者均在结膜下使用 PRGF 膜（mPRGF）进行小梁切除术作为辅助治疗。收集患者人口统计学数据和使用药物的数量。记录手术前、术后 8 天、1 个月、3 个月、6 个月、9 个月和 1 年的眼压。术后 6 个月根据 Moorfields 滤过泡分级系统对滤过泡形态进行分类。
共纳入 9 例 9 只眼。平均年龄为 71±5.1 岁，男性 6 例。平均眼压从术前 24.0±8.8mmHg 降至术后 1 年随访时的 12.9±2.6mmHg。术前降压药物的数量（均值±标准差）为 4.3±0.9 种，1 年后为 0.8±1.1 种。完全成功定义为眼压等于或低于 21mmHg，无需使用降眼压药物，合格成功定义为眼压等于或低于 21mmHg，需要使用药物。术后 1 年随访时完全成功率为 66.7%，合格率为 100%。
在本研究中，mPRGF 小梁切除术既安全又有效。记录到滤过泡高度较低（1.6±0.8）。mPRGF 可改善伤口愈合，产生更耐受、更有利的滤过泡，避免抗代谢物并发症。
