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The Effect of Dry Eye Disease on Scar Formation in Rabbit Glaucoma Filtration Surgery
Hong Ji1, Yingting Zhu2, Yingying Zhang3
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China. jihong@gzzoc.com.
Abstract:
The success rate of glaucoma filtration surgery is closely related to conjunctival inflammation, and the main mechanism of dry eye disease (DED) is inflammation. The aim of this study was to evaluate the effect of DED on bleb scar formation after rabbit glaucoma filtration surgery. Sixteen New Zealand white rabbits were randomly divided into control and DED groups. A DED model was induced by twice-daily topical administration of 0.1% benzalkonium chloride (BAC) drops for three weeks. Ocular examinations were performed to verify the DED model. Surgical effects were assessed, and histologic assessments were performed on the 28th postoperative day. Higher fluorescein staining scores, lower basal tear secretion levels and goblet cell counts, and increased interleukin 1β (IL-1β) levels were observed in the DED group. The DED eyes displayed significantly higher intraocular pressure (IOP)% on the 14th postoperative day; a smaller bleb area on days 14, 21 and 28; and a shorter bleb survival time. Moreover, proliferating cell nuclear antigen (PCNA) and alpha-smooth muscle actin (α-SMA) levels were significantly increased in the DED group. These results demonstrate that DED promotes filtering bleb scar formation and shortens bleb survival time; these effects may be mediated via IL-1β.
Insights
Dry eye disease (DED) worsens scarring after glaucoma surgery. Inflammation, particularly interleukin-1β (IL-1β), appears to drive these negative effects, reducing surgical success.
Area of Science:
- Ophthalmology
- Inflammation Research
- Surgical Outcomes
Background:
- Glaucoma filtration surgery success is linked to conjunctival inflammation.
- Dry eye disease (DED) is primarily an inflammatory condition.
Purpose of the Study:
- To investigate the impact of DED on filtering bleb scar formation post-glaucoma surgery in rabbits.
- To explore the role of inflammation in DED-related changes to bleb healing.
Main Methods:
- A DED model was created in New Zealand white rabbits using benzalkonium chloride (BAC) drops.
- Ocular examinations, surgical assessments, and histological analyses were performed.
- Key markers including IL-1β, PCNA, and α-SMA were quantified.
Main Results:
- DED rabbits showed increased fluorescein staining, reduced tear secretion, and elevated IL-1β.
- DED eyes had higher IOP, smaller bleb area, and shorter bleb survival.
- Increased PCNA and α-SMA levels indicated enhanced scarring in DED eyes.
Conclusions:
- DED promotes filtering bleb scarring and reduces bleb longevity after glaucoma surgery.
- Interleukin-1β (IL-1β) may mediate the detrimental effects of DED on bleb healing.
- These findings highlight the importance of managing DED in glaucoma patients undergoing filtration surgery.
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