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Related Experiment Videos

Filtering bleb encapsulation increased by steroid injection.

K Loftfield1, S F Ball

  • 1Department of Ophthalmology, Louisiana State University Medical Center, School of Medicine, New Orleans.

Ophthalmic Surgery
|April 1, 1990
PubMed
Summary
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Intra-Tenon

Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Drug Delivery Systems

Background:

  • Filtering surgery is a common procedure for glaucoma management.
  • Fibroblast proliferation can lead to encapsulation and failure of filtering surgery.
  • Dexamethasone is used to modulate wound healing and prevent encapsulation.

Purpose of the Study:

  • To evaluate the efficacy of intra-Tenon's dexamethasone administered directly over the fistula site in preventing encapsulation after filtering surgery.
  • To compare the encapsulation rates between intra-Tenon's and subconjunctival dexamethasone administration.

Main Methods:

  • 16 eyes underwent filtering surgery with intra-Tenon's dexamethasone injection directly over the fistula site.
  • A retrospectively matched group of 20 eyes received subconjunctival dexamethasone 180 degrees away from the filter site.

Related Experiment Videos

  • Encapsulation rates were compared between the two groups.

    • Main Results:

    • The intra-Tenon's group showed a significantly higher encapsulation rate (56%) compared to the subconjunctival group (10%).
    • Intra-Tenon's injection did not maintain adequate fibroblast inhibitory drug levels and appeared to promote fibroblastic growth.
    • No demonstrable benefit was observed with intra-Tenon's dexamethasone, despite increased encapsulation.

    Conclusions:

    • Intralesional dexamethasone administered directly over the fistula site is not recommended for filtering surgery due to increased encapsulation.
    • Prolonged topical steroid use beyond the initial inflammatory phase may increase fibrosis and encapsulation.
    • Topical steroids should be discontinued by the third postoperative week if inflammation permits to avoid excessive fibrosis.