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Effects of Gelatin Hydrogel Loading Mitomycin C on Conjunctival Scarring in a Canine Filtration Surgery Model
Shota Kojima1, Tetsuya Sugiyama2, Shinji Takai3
1Department of Ophthalmology Osaka Medical College, Takatsuki-City, Osaka, Japan.
Purpose:
To investigate the effects and toxicities of gelatin hydrogel (GH) loading mitomycin C (MMC) on IOP and conjunctival scarring in a canine model of glaucoma surgery in comparison with conventional MMC application.
Methods:
Glaucoma surgery models were made in six beagles. An MMC-loaded GH was implanted under the conjunctiva of one eye (GH-MMC group) and 0.04% MMC-soaked sponges were placed under the conjunctiva of the other eye (MMC group) for 5 minutes. Intraocular pressures and bleb features were then assessed for 4 weeks postoperative, followed by histological evaluation. The ratio of conjunctival area to scleral area, the densities of collagen and the numbers of fibroblasts, vessels, and proliferative cell nuclear antigen (PCNA)-positive cells were then quantified.
Results:
In both groups, IOP reduction and bleb formation were maintained in a similar manner for 4 weeks postoperative. No significant difference in the ratio of conjunctival area to scleral area was found between the two groups. Collagen density and the numbers of fibroblasts and vessels were significantly lower in the MMC-treated group than in the GH-MMC-treated group. No significant difference in PCNA-positive cells was found between the two groups.
Conclusions:
Implantation of MMC-loaded GH ameliorated toxicity to conjunctiva compared with the 5-minute placement of MMC, whereas its effect on IOP reduction and bleb formation was similar. These results suggest that using GH for the application of MMC is a safer method than the conventional application of MMC in glaucoma filtration surgery.
Insights
Gelatin hydrogel (GH) loaded with mitomycin C (MMC) reduced conjunctival toxicity in glaucoma surgery compared to conventional MMC application, with similar intraocular pressure reduction and bleb formation. This suggests GH is a safer MMC delivery method.
Area of Science:
- Ophthalmology
- Biomaterials Science
- Surgical Innovation
Background:
- Glaucoma filtration surgery aims to reduce intraocular pressure (IOP).
- Mitomycin C (MMC) is used to prevent conjunctival scarring but can cause toxicity.
- Novel drug delivery systems are needed to improve MMC safety and efficacy.
Purpose of the Study:
- To compare the effects and toxicities of gelatin hydrogel (GH) loaded with mitomycin C (MMC) versus conventional MMC application.
- To evaluate IOP reduction and conjunctival scarring in a canine glaucoma surgery model.
Main Methods:
- Canine glaucoma surgery models were created in six beagles.
- One eye received MMC-loaded GH implantation; the other received conventional 5-minute MMC-soaked sponge application.
- Postoperative IOP, bleb features, and histological parameters (collagen density, fibroblast, vessel, and PCNA-positive cell counts) were assessed for 4 weeks.
Main Results:
- Both GH-MMC and conventional MMC groups showed similar IOP reduction and bleb formation for 4 weeks.
- Conjunctival toxicity was reduced with GH-MMC, evidenced by significantly lower collagen density, fibroblast, and vessel counts compared to the conventional MMC group.
- No significant difference in the conjunctival-to-scleral area ratio or PCNA-positive cells was observed between groups.
Conclusions:
- Gelatin hydrogel (GH) loaded with mitomycin C (MMC) ameliorates conjunctival toxicity in glaucoma surgery compared to conventional MMC application.
- GH-MMC demonstrates comparable efficacy in IOP reduction and bleb formation.
- Using GH for MMC delivery represents a safer approach for glaucoma filtration surgery.
