| Objectives To evaluate the anti-cicatricial effect of methylprednisolone(MP) in glaucoma filtration compared with that of mitomycin(MMC) due to the use of the cotton patch soaked in 0.1ml MP of various concentrations during filtration surgery topically and one time on rabbit eyes.Methods 21 rabbits (42eyes) were divided in two groups randomly. The MP groups and the control groups consisting of 32 eyes and 10 eyes respectively underwent trabeculectomy. In MP groups cotton patch soaked in 0.1 ml MP of four different concentrations (20mg/ml, 50mg/ml, 100mg/ml and 200mg/ml were named MP 1, MP 2, MP 3 and MP 4 respectively) was used under conjunctival flap for five minutes intraoperatively, randomly and averagely while in control groups 0.2mg/ml MMC (control 2) and N-S (control 1) were used instead. Intraocular pressure(IOP) and bleb were observed postoperatively. A month later, the animals were killed and histopathological and immunohistochemical detections were performed. Image analysis system was used to detect collagenareas. Statistical analysis was conducted. Results 1. IOP change: Three days after filtration, IOP in all MP groups had a significant drop. The same thing occurred one week later. In MP 2,MP 3 and MP 4, IOP decreased significantly one month after filtration (P<0.05). In MP 1, there was no significant difference between preoperative IOP and postoperative IOP. Compared with control 2 in all MP groups, there was no significant difference among them except MP 1. Compared with control 1, the condition is opposite. 2. bleb life-span: In control 1, bleb life-span was 1-5 days and it was 1-6 days in MP 1. But bleb life-span prolonged prominently in other groups. It was 9-30 days in MP 2,14-30 days in MP 3 and 12-30 days in MP 4. Control 2 had still 80% functional blebs at the end of the study. 3. histopathological change: H-E staining revealed that in control 1 and MP 1 there were large number of inflammatory cells infiltrated under global conjunctiva, hyperplasia tissues were evident and collagen tissues were compact. Control 2 showed that subconjuntival inflammatory cells reduced and hyperplastic phenomenon is slight. Other MP groups had close results with MMC group. 4. Image analysis: Subjunctival collagen areas was largest in control 1 and smallest in control 2. Difference betweenthem was significance. Compared with control 1, MP 2, MP 3 and MP 4 had statistical significance. 5. Immunohistochemical staining revealed PCNA positive cells under global conjunctiva were most in control 1 and MP 1. Positive cell count of the two groups had a significant difference compared with that of MP 2JVIP 3,MP 4. The distribution of positive cells was diffuse and brown granules could be seen. Cell nuclear was pigmented deeply. There were fewer positive cells in other groups. The change tendency from few to many is control 2, MP3→MP2, MP4→control 1, MP1 Conclusions 1. Methylprednisolone(MP) is a very potential anti-scar drug and can elevate successful rate of rabbit filtration. 2. Used in the way of cotton patch, MP has lower ocular toxicity. Samely, high concentration could be got topically. 3. In definite range, the activity of MP is concentration-dependent. In other words, the activity can be promoted with the increase of concentration. Total results considered, 100mg/ml MP group is identified to have the best effect of all MP groups in the experiment. |
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