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Safety and efficacy of photodynamic therapy using BCECF-AM compared to mitomycin C in controlling post-operative fibrosis in a rabbit model of subscleral trabeculectomy

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International Journal of Ophthalmology(English edition) 2016年第3期9卷 348-356页

作者： Azza Mohamed Ahmed Said rania gamal eldin zaki Thanaa Helmy Mohamed Manal Ibraheem Salman Department of Ophthalmology Faculty of Medicine Ain Shams University Cairo 11361 Egypt Department of Pathology Faculty of Medicine Ain Shams University Cairo 11361 Egypt

AIM： To evaluate the safety and efficacy of cellular photoablation using BCECF-AM [2, T-bis-（2-carboxyethyl） -5-（and-6）-carboxyfluorescein, acetoxymethyl ester mixed isomersl as a method to control postoperative fibrosis in subscleral trabeculectomy （SST） compared to mitomycin C （MMC） in a rabbit model. METHODS： A comparative prospective case-control animal study was conducted. Fourteen rabbits were subjected to SST with intraoperaUve use of wound modulating agents （MMC or BCECF-AM） of the right eye （study groups I and II respectively） and SST without use of intraoperative wound modulating agents for the left eye （control group II）. Two rabbits 4 eyes were considered as control group I with no surgical intervention. BCECF-AM was injected subconjunctivally 30min before surgery followed by intraoperative illumination with diffuse blue light for 10min. Antifibrotic efficacy was established by clinical response and histological examination. Clinical response was assessed by measuring intraocular pressure （lOP） at day 1, 3, 5, 7, 14, 21 postoperatively, Success was defined by 〉20.0% reduction in lOP from the preoperative values without anti-glaucoma medications. RESULTS： The mean percentage of reduction was 35.0% in the study group I with only one eye （14.3%） had 12.5% reduction. The mean percentage of reduction was 28.0% in the study group U with two eyes （28.6%） in study group II had 14.2% reduction each. Regarding the control group II, the mean percentage of reduction was 14.3% with 64.3% eyes had 〈20.0% reduction. There was a highly statistically significant difference between each of the study groups （right eyes） and the corresponding control group II （left eyes） as regards the mean postoperative lOP values started from day 5 in both study groups and this highly significant difference remained so till the end of the follow up period. Histologically, MMC treated blebs showed thinning of conjunctival epithelium with marked reduction of the goblet cells relative to con

关键词： subscleral trabeculectomy mitomycin C photodynamic therapy BCECF-AM intraocular pressure cellular photoablation

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