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Filtration Surgery (filtration + surgery)
Selected Abstracts2164: Role of placental growth factor (PIGF) in wound healing after glaucoma filtration surgeryACTA OPHTHALMOLOGICA, Issue 2010T VAN BERGENArticle first published online: 23 SEP 2010 Purpose Failing filtering surgery due to excessive wound healing is a considerable challenge in ophthalmology, and largely contributes to progressive vision loss in glaucoma patients. Anti-VEGF therapy helps to prevent post-surgical scarring by inhibiting angiogenesis and collagen deposition, but does not influence inflammation (which is also an important player in postoperative wound healing). We will check the hypothesis that placental growth factor (PlGF) plays a role in scar formation after glaucoma filtration surgery, and that it may be a(n) (additional) target for improvement of the outcome of this surgery through its known anti-angiogenic and anti-inflammatory, and possibly anti-fibrotic properties. Methods The effect of an anti-PlGF antibody (ThromboGenics) will be investigated in vitro on the proliferation of endothelial cells (HUVEC), inflammatory cells (Jurkat cells) and of Tenon fibroblasts (TF). The effect of the antibody will also be investigated in vivo in a rabbit model for glaucoma surgery by measuring intra-ocular pressure (IOP), filtration bleb function and survival, and by (immuno-)histological analysis of angiogenesis (CD31), inflammation (CD45) and fibrosis (Sirius Red). Conclusion Our proposed research project will elucidate the potential role of PlGF-inhibition in the improvement of filtration surgery outcome, and will highlight any angiostatic, anti-inflammatory, and/or anti-fibrotic effects. PlGF-inhibition as an adjuvant anti-inflammatory therapy to anti-VEGF treatment in glaucoma surgery might open new perspectives for more efficient surgery. In conclusion, our project opens exciting perspectives for the treatment of the blinding condition of glaucoma, and thus might improve the visual prognosis of glaucoma patients. [source] The effect of microplamin on wound healing after glaucoma filtration surgeryACTA OPHTHALMOLOGICA, Issue 2009T VAN BERGEN Purpose The outcome of trabeculectomy can be diminished due to a decreased bleb function secondary to blood/ fibrin clot in the aqueous outflow pathway. The aim of this study is to investigate whether the administration of Microplasmin (ThromboGenics), a recombinant protein that dissolves clot and fibrin, could lead to a better maintenance of the constructed channel, and thus improve surgical outcome after trabeculectomy. Methods The effect of Microplasmin will be investigated in vivo in a mouse model for conjunctival fibrosis and in a rabbit model for glaucoma surgery. Postoperative follow up of the animals will take place daily during the first week and two-daily until they are scarified. On specific time points animals will be sacrificed and both eyes will be enucleated. Seven-µm thin slides will be (immuno-)stained for CD45 to evaluate inflammation and for Sirius red and Trichrome to evaluate fibrosis. Results Preliminary results showed that Microplasmin significantly improved glaucoma surgery outcome in the rabbit model of aggressive scarring compared to control. Conclusion Our proposed research project will elucidate the potential role of Microplasmin in the improvement of filtration surgery outcome, and will highlight any anti-clotting, anti-inflammatory, and/or anti-fibrotic effects of this molecule. Microplasmin as an adjuvant therapy in glaucoma surgery might open new perspectives for more efficient surgery. [source] Can preoperative bevacizumab improve trabeculectomy outcome?ACTA OPHTHALMOLOGICA, Issue 2009Avastin-Trab study Purpose The aim of this project is to study whether peroperative intracameral bevacizumab (Avastin®) might improve the outcome of filtration surgery. Methods This study will be carried out in a prospective, placebo-controlled, double-blinded experimental setup. The effect of peroperative administration of bevacizumab on intraocular pressure, bleb characteristics and post-operative medication and surgical intervention will be investigated. The risk of systemic side-effects will minimalized by using local anti-Vascular Endothelial Growth Factor treatment. The study patients will be divided into two major groups: A) Patients with primary open angele glaucoma and B) Patients with normotensive glaucoma, in which very low IOPs are targeted. Both groups of patients will undergo a trabeculectomy. Patients in group A will not be given the antimetabolite Mitomycin C (MMC), while patients in group B will receive MMC to obtain sufficiently low IOPs. This strategy adheres to standard operating procedures for filtration surgery. Results will follow Conclusion Our study will potentially shed new light on a plausible and simple method to improve the prognosis of glaucoma filtration surgery. Since this study will provide direct data on the effectiveness of a one-time treatment that might reduce the risk of bleb failure after filtration surgery, avoiding or reducing the need for long-term medication use or secondary surgical intervention, the potential clinical implications of this study are clear. Thus, our project opens exciting new perspectives for the treatment and prognosis of the blinding condition of glaucoma [source] The effect of scleral flap edge apposition on intraocular pressure control in experimental trabeculectomyCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 4 2008Wayne Birchall Abstract Background:, To assess the contribution of scleral flap edge apposition to intraocular pressure (IOP) control in trabeculectomy, using a previously described and validated experimental model of guarded filtration surgery. Materials and methods:, Twelve rectangular-flap trabeculectomy operations each with two apical adjustable sutures were performed on six donor human eyes connected to a constant flow infusion with real-time IOP monitoring. Three sizes of scleral flap were created: 4 × 4 mm, 16 mm2 (n = 4), 3 × 3 mm, 9 mm2 (n = 4) or 3 × 2 mm, 6 mm2 (n = 4). Sutures were tied tightly to produce high aqueous outflow resistance, and equilibrium IOP established. The lateral and posterior edges of the scleral flap were removed, the sutures tightened again, and the new equilibrium IOP measured. Results:, Following flap closure and with intact flap edges, the mean absolute IOP for all flaps (n = 12) was 19.5 ± 3.9 mm Hg (mean ± SD, range 12.4,27 mm Hg) and following flap edge excision 18.7 ± 4.4 mm Hg (range 5.6,27.9 mm Hg), demonstrating no significant difference between flaps with edge apposition compared with those without (P = 0.33). Mean relative IOP (% of baseline) was 68.4 ± 12.1% (range 40.9,94%) with intact flap edges and 65.4 ± 14.5% (range 18.5,97.2%) following flap edge excision (P = 0.31). Flaps measuring 4 × 4 mm and 3 × 3 mm behaved in a similar manner with minimal change in equilibrium IOP following excision of flap edges. Conclusions:, In this experimental model, scleral flap edge apposition is not required for generating outflow resistance. Suture tension generated during tight flap closure produces apposition of the underside of the scleral trapdoor to the underlying bed, and it is this apposition, which determines IOP. [source] | ||||||||||