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Updated: Dec 13, 2025
Induction of Ocular Surface Inflammation and Collection of Involved Tissues
Published on: August 4, 2022
The Inflammatory and Foreign Body Reaction of Polymethyl Methacrylate Glaucoma Drainage Device in the Rabbit Eye
Virna D Oktariana Asrory1,2, Ratna Sitompul1,2, Widya Artini1,2
1Ophthalmology Department, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
Purpose:
To assess the safety and tissue response of a polymethyl methacrylate (PMMA) glaucoma drainage device (GDD) in the rabbit eye.
Methods:
Specially constructed PMMA GDD devices were implanted into rabbit eyes and evaluated histopathologically following euthanasia on days 5, 30, and 60 after implantation surgery. Hematoxylin-eosin, Masson's trichrome, and periodic acid-Schiff were used to stain tissue specimens dissected from the surgical site. Inflammatory cell count and capsule thickness measurements were performed.
Results:
Three rabbits were sacrificed on day 5, 3 on day 30, and 4 on day 60. Macrophage and lymphocyte counts increased from day 5 to day 30 then decreased (P = 0.0000) with greater counts seen in the superior regions. At day 30, a fibrous capsule had formed around the plate area. Fibroblast counts increased significantly between day 5 to day 30 and again to day 60 (P = 0.001) with greatest numbers anteriorly. The inferior capsule thickness at day 60 was 243 µm (standard deviation, 120; 95% confidence interval: 53-433). The superior capsule thickness was 388 µm (standard deviation, 136; 95% confidence interval: 172-604). No adverse reactions were seen.
Conclusions:
Histopathologically, the inflammatory response toward this PMMA glaucoma drainage device was comparable to other reported GDDs. No accentuated response or adverse event was seen suggesting that PMMA may be useful as a GDD material.
Translational Relevance:
An affordable, locally built GDD is needed in Indonesia because of the high prevalence of severe glaucoma. This rabbit study is a significant step toward justifying the use of PMMA as a GDD material. PMMA is cheap and easily manufactured and sterilized in developing economies.
Insights
Polymethyl methacrylate (PMMA) glaucoma drainage devices (GDDs) showed a safe tissue response in rabbit eyes. This suggests PMMA is a viable material for affordable glaucoma implants, especially in developing economies.
Area of Science:
- Ophthalmology
- Biomaterials Science
- Histopathology
Background:
- Glaucoma drainage devices (GDDs) are crucial for managing severe glaucoma.
- There is a need for affordable GDDs, particularly in regions like Indonesia.
- Polymethyl methacrylate (PMMA) offers potential as a cost-effective GDD material due to its manufacturability and sterilizability.
Purpose of the Study:
- To evaluate the safety and tissue response of a polymethyl methacrylate (PMMA) glaucoma drainage device (GDD) in a rabbit eye model.
- To histopathologically assess the inflammatory and cellular responses to PMMA GDD implantation.
- To determine the feasibility of using PMMA as a material for glaucoma drainage devices.
Main Methods:
- PMMA GDDs were surgically implanted into rabbit eyes.
- Histopathological analysis using Hematoxylin-eosin, Masson's trichrome, and PAS staining was performed on explanted tissues.
- Key metrics included inflammatory cell counts (macrophages, lymphocytes) and fibrous capsule thickness at 5, 30, and 60 days post-implantation.
Main Results:
- Inflammatory cell counts peaked at day 30 and then decreased, with no adverse reactions observed.
- A fibrous capsule formed around the GDD plate by day 30, with increasing thickness over time.
- Fibroblast counts significantly increased from day 5 to day 60, indicating tissue integration.
Conclusions:
- The inflammatory response to PMMA GDDs was comparable to other GDD materials.
- No adverse events or accentuated inflammatory responses were noted, supporting PMMA's biocompatibility.
- PMMA is a promising material for developing safe and affordable glaucoma drainage devices.
