Antifibrotics and wound healing in glaucoma surgery

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Paul J Lama1, Robert D Fechtner

  • 1Glaucoma Division, New Jersey Medical School, Newark 07103, USA.

Survey of Ophthalmology
|May 15, 2003
PubMed

Insights

Glaucoma surgery success depends on controlling wound healing. This review examines anti-fibrotic agents like 5-fluorouracil and mitomycin C, and steroids to improve surgical outcomes and reduce complications.

Area of Science:

  • Ophthalmology
  • Surgical Science
  • Pharmacology

Background:

  • Glaucoma filtration surgery is essential when medical and laser therapies fail to manage intraocular pressure.
  • Surgical success hinges on modulating the wound-healing response to maintain the new filtration pathway's patency.

Purpose of the Study:

  • To review the wound-healing pathway in glaucoma surgery.
  • To analyze pharmacologic interventions used to interrupt wound healing.
  • To evaluate agents like steroids, 5-fluorouracil, and mitomycin C for enhancing surgical success and managing complications.

Main Methods:

  • Comprehensive review of published literature on wound healing in glaucoma surgery.
  • Critique and interpretation of clinical and experimental studies using anti-fibrotic agents and steroids.
  • Analysis of agent efficacy, complications, and future therapeutic directions.

Main Results:

  • Steroids, 5-fluorouracil, and mitomycin C have been employed to inhibit wound healing and improve filtration surgery success rates.
  • These agents are associated with specific complications that require careful consideration and management.
  • The effectiveness and safety profiles of these interventions vary, necessitating a balanced approach.

Conclusions:

  • Pharmacologic modulation of wound healing is critical for successful glaucoma filtration surgery.
  • Careful selection and application of anti-fibrotic agents and steroids are necessary to balance efficacy and safety.
  • Emerging agents targeting pathways like anti-transforming growth factor beta 2 offer future potential for improved outcomes.

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