Connexin43 modulation inhibits scarring in a rabbit eye glaucoma trabeculectomy model

We investigated whether one subconjunctival injection of connexin43 antisense oligodeoxynucleotides (Cx43 AsODN) modulates postoperative scarring in a rabbit model of glaucoma trabeculectomy surgery. In a randomised, controlled, masked-observer study, 39 rabbits underwent trabeculectomy surgery with insertion of a 22-gauge cannula in the right eyes and were randomly divided into three treatment groups. Each rabbit received an injection of Cx43 AsODN in Pluronic gel, balanced salt solution or Pluronic gel alone into the formed bled. The animals were euthanized at 8 and 24 h and at 5 and 21 days. Histology and immunohistochemistry results demonstrated that Cx43 AsODN decreased Cx43 upregulation at 8 and 24 h which led to less myofibroblast upregulation at days 5 and 21 and reduced scarring at day 21 compared to controls. We conclude that postoperative use of Cx43 AsODN inhibited subconjunctival scarring and fibrosis. Cx43 AsODN injection may be a safe and effective anti-scarring agent in glaucoma trabeculectomy surgery.