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Prevention of ocular scarring post glaucoma filtration surgery using the inflammatory cell and platelet binding

Jeff Min1, Zachary L Lukowski, Monica A Levine

  • 1Department of Ophthalmology, College of Medicine, University of Florida, Gainesville, Florida, United States of America.

Plos One
|May 5, 2012
PubMed
Abstract

Insights

Saratin, when applied topically and with injections, significantly prolonged bleb survival after glaucoma surgery in rabbits. This new anti-fibrosis agent offers a safer alternative to mitomycin-C, avoiding toxicity.

Area of Science:

  • Ophthalmology
  • Regenerative Medicine
  • Surgical Innovation

Background:

  • Glaucoma filtration surgery (GFS) often requires antimetabolites to prevent scarring, but these can cause late complications.
  • Safer, targeted anti-fibrosis agents are needed to improve outcomes after GFS.
  • Saratin, a protein with known anti-fibrotic properties, has not been previously studied in the context of glaucoma surgery.

Purpose of the Study:

  • To evaluate the efficacy of saratin in prolonging bleb survival following GFS in a rabbit model.
  • To compare saratin's performance against mitomycin-C (MMC), a standard anti-scarring agent.
  • To assess two different saratin delivery methods: intraoperative topical application alone versus combined topical application with postoperative injections.

Main Methods:

  • Twenty-four New Zealand White rabbits underwent GFS.
  • Interventions included: intraoperative topical saratin, topical saratin plus two postoperative injections, balanced saline solution (BSS), or MMC.
  • Bleb survival and tissue characteristics were assessed clinically and histologically.

Main Results:

  • Saratin administered via topical application plus injections significantly increased mean bleb survival to 33.6 days compared to BSS controls (17.4 days, p=0.018).
  • Intraoperative topical saratin alone did not improve bleb survival over BSS (15.5 days, p=0.749).
  • Saratin treatment did not result in bleb avascularity or thinning, unlike MMC, and showed no signs of toxicity.

Conclusions:

  • A regimen of intraoperative topical saratin combined with postoperative injections effectively prolonged bleb survival after GFS, comparable to MMC.
  • This saratin treatment strategy demonstrated a favorable safety profile, avoiding the toxicities associated with MMC.
  • Topical saratin application alone was insufficient to enhance bleb longevity in this model.

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