Experimental Study Of Adjunctive IH764-3 On Glaucoma Filteration Surgery

Objective: Trabeculotomy is the classic operation in theglaucoma filtering surgery, but it causes filtering bleb scaringand leads to the surgery failure, because of the breakage of theblood-aqueous barrier, inflammation after the surgery, and theproliferation of filbroblast. In recent years clinical doctors haveused the antiscaring drugs in or after the operation, such as 5-FU,MMC…etc. It has some effect on improving filtering bleb,decreasing the intraocular pressure, and making the operationsuccessfully. But it can bring some side-effect and complication.Some drugs have serious toxicity and suffer the certainrestriction, so we need to explore a kind of drugs of inhibitingscar on the glaucoma filtering surgery. It can be completelyabsorbed. It also has high effect and little toxicity. We observedits effect of decreasing the intraocular pressure,percentage ofthe functional blebs,antiproliferative role of the fibroblast andconfiguration in the course of wound healing. Our object is toevaluate the effects of IH764-3 on inhibiting scar formation inthe glaucoma filtering surgery.Methods:1 Animals Forty New Zealand white rabbitswere randomly divided into four groups. Each group has 8rabbits. We operated on every rabbit eye according to standardof trabaculactomy. The first group ( control ) receivedintracameral normal saline after surgery. The second group,experiment Ⅰgroup and experiment Ⅱgroup received 5-FU(25mg/mL )2ml,IH764-3(2mg/ml)2ml,IH764-3(5mg/ml)2mlevery day in the frist week after surgery and every two days inthe second week after surgery.2 Intraocular pressure measurement : Intraocularpressure(IOP) measurements were performed before surgery andon postoperative days 3,7,15,30 respectively. We comparedthe difference among the four groups on different stages.3 Slit-lamp microscope examination We observedthe rabbits'filtration blebs,corneal epithelium and conjunctivalwound on postoperative days 3,7,15,30 and compared thepercentage of injured corneal epithelium and the functionalblebs.4 Histopathology One rabbit were killed onpostoperative days 3,7,15,30 every group. We kept theirfiltration blebs,enucleated their eyes,fixed them,made paraffinslices. We observed the filtration passage by performing HEstaining, the micro-structrure of the scar in the cut under theelectron microscope. We observed the expression ofproliferative cell nuclear antigen (PCNA) in the filtration areaand counted the number of positive cell nuclear undermicroscope after performing immunohistochemical staining.Results: 1 The change of the intraocular pressure : Therewas no significant difference among four groups beforeoperation and postoperative days 3 (P>0.05). The differencewas significant between the saline group and other three groupsafter postoperative days 3. There was no significant differencebetween the 5-FU group and experiment Ⅰgroup postoperativedays 7,15 and 30(P<0.05). But the difference was significantbetween the 5-FU group and experiment Ⅱgroup postoperativedays 7,15 and 30(P<0.05).2 The comparison of filtration blebs: There was nodifference on the percentage of the filtration blebs among fourgroups on postoperative days 3, but it was higher in theexperiment Ⅱgroup than the 5-FU group and experiment Ⅰgroup postoperative days 15 and 30.3 The comparison of the percentage of opened filtrationpassage The result is the same as that of HE staining.4 The comparison of injured corneal epithelium andconjunctival leaking wound: the percentage of injured cornealepithelium of two experiment groups was lower that of the 5-FUgroup at days 3,7 after surgery. All corneal healed up at 15 daysafter surgery. There are one eye with corneal leaking wound inthe 5-FU group. It was not found in tow experiment geoups.5 Histopathology observationHE staining All filtration passage were opened at 3days after surgery. the percentage of opened filtration passagewas higher in experiment Ⅱgroup than the 5-FU group andexperiment Ⅰgroup postoperative days 15 and 30.Immunohistochemical staining. The number of PCNA...