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An Epithelial Abrasion Model for Studying Corneal Wound Healing
Published on: December 29, 2021
Aberrant wound-healing response in mitomycin C-treated leaking blebs: a histopathologic study
Victor M Elner1, Paula Anne Newman-Casey, A Jayaprakash Patil
1Department of Ophthalmology & Visual Sciences, University of Michigan, Ann Arbor, USA.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|August 12, 2009
Summary
Mitomycin C (MMC)-treated filtering blebs with persistent leaks show abnormal wound healing, including acellular stroma and myxoid changes. Achieving a robust fibrovascular response is crucial for stable filtration blebs.
Area of Science:
- Ophthalmology
- Histopathology
- Glaucoma Surgery
Background:
- Mitomycin C (MMC) is used to enhance glaucoma filtration surgery success.
- Persistent leaks from MMC-treated filtering blebs can lead to complications.
- Aberrant wound healing is implicated in bleb failure.
Purpose of the Study:
- To histopathologically characterize leaking MMC-treated filtering blebs.
- To identify features associated with persistent conjunctival thinning and leakage.
- To understand the wound healing processes contributing to bleb failure.
Main Methods:
- Histopathological examination of 40 excised leaking MMC-treated filtering blebs.
- Utilized hematoxylin-eosin, PAS, Masson trichrome, and Alcian blue stains.
- Correlated histopathologic findings with clinical presentation of persistent leaks.
Main Results:
- 90% of leaking blebs had epithelial-stromal domes with acellular stroma and attenuated epithelium.
- 75% showed fibrovascular repair from the bleb margin.
- 65% exhibited Alcian blue-positive myxoid stroma, significantly associated with fibrovascular proliferation (P = .002).
Conclusions:
- Adequate fibrovascular response is essential for a stable filtration bleb barrier.
- Fibroblasts should deposit collagen, not myxoid stroma, for bleb stability.
- Surgical techniques and post-operative care should promote optimal fibrovascular healing.
