10-Hydroxycamtothecin In Modulation Of Wound Healing After Glaucoma Filtering Surgery

Objective：To investigate whether topical administration of10-hydroxycamtothecin could beused to prevent postoperative scarring in rabbit model of experimental glaucomafiltration surgery.Methods:Trabeculectomy was performed on40New Zealand white rabbits. The rabbitswere then randomized into4groups and received0.3mg/mL mitomycin C，or0.3mg/mL10-hydroxycamtothecin, or1.0mg/mL10-hydroxycamtothecin or normalsaline solution beneath the conjunctival flap and scleral flap during trabeculectomyfor5minutes in the right eyes of10rabbits. Before and after the surgery (days1,4,7,14,21, and28), intraocular pressure (IOP) was measured in both eyes with icaretonometer. After surgery， slit-lamp examination and fundus examination wereperformed． The morphology of filtering blebs， the presence and intensity ofconjunctival congestion，corneal opacity or staining，anterior chamber aqueous flare，incision of peripheral iris， opacity of lens and retinal were observed andrecorded．The animals were killed on days7,14,and28. Histopathology (hematoxylinand eosin staining， Masson trichrome method) was performed to determine theamount of scarring and fibrosis.Results：There were significant differences among groups （F=20.79，P<0.01）.Statistically significant differences between the seven time point were found（F=85.34，P<0.01）. Intraocular pressure variation for each time point differences inthe four groups before and after surgery（F=2.13，P<0.05）.No significant differences were found in the change of IOP among4groups before operation (P>0.05). Thedecrease of IOP from baseline remained to PODs28in1.0mg/mL10-hydroxycamtothecin group as well as MMC group. It was longer than surgerywith normal saline solution and0.3mg/mL10-hydroxycamtothecin.1.0mg/mL10-hydroxycamtothecin and MMC significantly prolonged bleb survival, and theblebs were lager and higher than those in the control group (P<0.01); the0.3mg/mL10-hydroxycamtothecin group was less effective. The histological examination andMasson trichrome showed that1.0mg/mL10-hydroxycamtothecin and MMC groupshad less scarring and inflammatory cells in filtering tunnel at day7to28than thecontrols.Conclusions：In conclusion, in this experiment,with the examination of pathological,wediscovered that the process of scarring after glaucoma filtration was consistent withdescribtion of the literature,therefore the experimental model of the present experimentwas feasible.By the research of pharmacology and stability of curcumin,showed that itwas configured as eye ointment for the anti—trabeculectomy scarring was an effectiveand feasible method.10-hydroxycamtothecin can inhibit the inflammatory responseand collagen fibrosis and therefore open the filtering tunnel after it be used topicallyduring the glaucoma trabeculectomy.