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Effect of topical aclacinomycin on glaucoma filtration surgery in rabbits
1Laboratory of Glaucoma, Henan Institute of Ophthalmology, Zhengzhou, China.
Abstract:
A prospective, randomized, double-masked and placebo-controlled study was performed to compare the effects of a single 5-minute intraoperative exposure to aclacinomycin (AMC) 0.4 mg/ml or 0.8 mg/ml with control eyes treated with saline solution on the success of glaucoma filtration surgery in 26 rabbits. Intraocular pressure (IOP), bleb survival, fistula patency and complications were evaluated. The results showed that IOP in the eyes treated with AMC was significantly lower than that in the control eyes from days 5-40 in the 0.4 mg/ml group and from days 5-20 in the 0.8 mg/ml group. The bleb survival lasted significantly longer in the two treated groups than in the control group and in the AMC 0.4 mg/ml group than in the AMC 0.8 mg/ml group. At 40 days, the rate of sclera fistula occlusion was 0% in the AMC 0.4 mg/ml eyes, 43.8% in the AMC 0.8 mg/ml eyes, and 100% in the control eyes. Significant complications, such as anterior chamber inflammation, hyphema, moderate and severe corneal haze, dense corneal neovascularization and mild cataract occurred only in the eyes treated with AMC 0.8 mg/ml. The results indicated that intraocular treatment with AMC at a dose of 0.4 mg/ml had a markedly beneficial effect on IOP, bleb appearance and fistula patency after experimental filtration surgery in rabbits.
Insights
Aclacinomycin (AMC) at 0.4 mg/ml improved glaucoma surgery success in rabbits by lowering intraocular pressure and enhancing bleb survival. Higher doses caused complications, indicating a beneficial therapeutic window for AMC.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Pharmacology
Background:
- Glaucoma filtration surgery success is often limited by scar tissue formation and subsequent failure.
- Novel therapeutic agents are needed to improve surgical outcomes and reduce intraocular pressure (IOP).
Purpose of the Study:
- To evaluate the efficacy and safety of intraoperative aclacinomycin (AMC) in a rabbit model of glaucoma filtration surgery.
- To determine the optimal concentration of AMC for enhancing surgical success while minimizing adverse effects.
Main Methods:
- Prospective, randomized, double-masked, placebo-controlled study in 26 rabbits.
- Intraoperative exposure to AMC (0.4 mg/ml or 0.8 mg/ml) or saline solution.
- Evaluation of intraocular pressure (IOP), bleb survival, fistula patency, and complications over 40 days.
Main Results:
- AMC treatment significantly reduced IOP compared to controls.
- Bleb survival was prolonged in AMC-treated eyes, particularly with the 0.4 mg/ml concentration.
- Fistula patency was 100% with AMC 0.4 mg/ml at 40 days, versus 43.8% with AMC 0.8 mg/ml and 100% occlusion in controls.
- Adverse events (inflammation, hyphema, corneal haze, neovascularization, cataract) occurred only with AMC 0.8 mg/ml.
Conclusions:
- Intraoperative aclacinomycin (AMC) at 0.4 mg/ml demonstrates significant benefits for glaucoma filtration surgery in rabbits.
- AMC enhances IOP reduction, bleb survival, and fistula patency.
- The 0.8 mg/ml concentration of AMC is associated with significant ocular complications, suggesting a narrow therapeutic window.