Effects of tranilast on filtering blebs: a pilot study

Area of Science:

• Ophthalmology
• Surgical Innovation
• Pharmacological Research

Background:

• Glaucoma filtering surgery, such as trabeculectomy, aims to reduce intraocular pressure (IOP).
• Post-surgical complications, including bleb vascularization and inadequate filtration, can impact long-term IOP control.
• Tranilast, an anti-fibrotic agent, has potential therapeutic benefits in ocular surgery.

Purpose of the Study:

• To evaluate the efficacy of topical 0.5% tranilast eye drops in managing intraocular pressure (IOP) and modulating filtering bleb characteristics after glaucoma surgery.
• To assess the impact of tranilast on bleb vascularization, size, and the incidence of pseudopod formation.

Main Methods:

• A prospective, randomized, double-masked, controlled clinical trial involving 52 patients undergoing trabeculectomy.
• Patients received either 0.5% tranilast eye drops or a vehicle saline solution four times daily for three months.
• Intraocular pressure (IOP) and filtering bleb features (vascularization, size, pseudopod formation) were monitored post-surgery.

Main Results:

• Tranilast-treated eyes showed a higher incidence of vascularized blebs and pseudopod formation compared to controls.
• Significantly larger bleb size was observed in the tranilast group at 6 and 12 months post-surgery.
• A more significant reduction in intraocular pressure (IOP) was sustained for up to two years in eyes treated with tranilast.

Conclusions:

• Topical tranilast eye drops effectively alleviate ischemia in the filtering bleb post-glaucoma surgery.
• Tranilast treatment leads to increased bleb size and a more substantial reduction in intraocular pressure (IOP).
• The study suggests tranilast is a safe adjunct therapy, with no vision-threatening side effects observed.