Skip to main content

Advertisement

SpringerLink
Log in

Seprafilm as a new antifibrotic agent following trabeculectomy in rabbit eyes

  • Laboratory Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the efficacy of Seprafilm (Genzyme, Framingham, MA, USA) in preventing postoperative adhesion between the conjunctiva and sclera after glaucoma filtering surgery.

Methods

A subconjunctival pocket was created and Seprafilm was inserted into the pocket in nine rabbits (Seprafilm group), whereas in a second group, a subconjunctival pocket was created in nine rabbits but no Seprafilm was inserted (non-Seprafilm group). The postoperative adhesion force was measured 4 weeks after surgery. For the trabeculectomy study, trabeculectomy was performed and Seprafilm placed on the scleral flap in five rabbits (Seprafilm trabeculectomy group), whereas in a second group, trabeculectomy was performed in five rabbits but no Seprafilm was placed (non-Seprafilm trabeculectomy group). Filtering bleb formation and intraocular pressure (IOP) was evaluated on days 1, 3, 5, 7, 14, 21, and 28 following surgery. The eyes were enucleated for histologic evaluation 4 weeks after surgery.

Results

The mean adhesive force between the conjunctiva and sclera in the Seprafilm group (125.6 ± 94.5 mmHg) was lower than that of the non-Seprafilm group (263.3 ± 79.3 mmHg) (P = 0.0041, unpaired t test). A more prominent bleb was observed in the Seprafilm trabeculectomy group than in the non-Seprafilm trabeculectomy group. Histologically, the subconjunctival space was larger in the Seprafilm trabeculectomy group than in the non-Seprafilm trabeculectomy group. Mean IOP was significantly lower in the Seprafilm trabeculectomy group (9.9 ± 0.6 mmHg) than in the non-Seprafilm trabeculectomy group (11.9 ± 0.7 mmHg) 4 weeks after surgery (P = 0.0044, unpaired t test).

Conclusions

Seprafilm can reduce postoperative conjunctiva-sclera adhesion and may be a desirable antifibrotic agent for trabeculectomy in the early stages of wound repair.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Addicks EM, Quigley HA, Green WR, Robin AL. Histological characteristics of filtering blebs in glaucomatous eyes. Arch Ophthalmol 1983;101:795–798.

    Article  CAS  PubMed  Google Scholar 

  2. Jampel HD, McGuigan LJB, Dunkelberger GR, et al. Cellular proliferation after experimental glaucoma filtration surgery. Arch Ophthalmol 1988;106:89–94.

    Article  CAS  PubMed  Google Scholar 

  3. The Fluorouracil Filtering Surgery Study Group. Fluorouracil Filtering Surgery Study one-year follow-up. Am J Ophthalmol 1989;108:625–635.

    Article  Google Scholar 

  4. Sinnreich Z, Barishak R, Stein R. Leaking filtering blebs. Am J Ophthalmol 1978;86:345–349.

    Article  CAS  PubMed  Google Scholar 

  5. Zacharia PT, Deppermann SR, Schuman JS. Ocular hypotony after trabeculectomy with mitomycin C. Am J Ophthalmol 1993;116:314–326.

    Article  CAS  PubMed  Google Scholar 

  6. Costa VP, Wilson RP, Moster MR, Schmidt CM, Gandham S. Hypotony maculopathy following the use of topical mitomycin C in glaucoma filtration surgery. Ophthalmic Surg 1993;24:389–394.

    CAS  PubMed  Google Scholar 

  7. Nuyts RM, Greve EL, Geijssen HC, Langerhorst CT. Treatment of hypotonous maculopathy after trabeculectomy with mitomycin C. Am J Ophthalmol 1994;118:322–331.

    Article  CAS  PubMed  Google Scholar 

  8. Higginbotham EJ, Stevens RK, Musch DC, et al. Bleb-related endoophthalmitis after trabeculectomy with mitomycin C. Ophthalmology 1996;103:650–656.

    Article  CAS  PubMed  Google Scholar 

  9. Peck LS, Quigg JM, Fossum GT, Goldberg EP. Evaluation of CMC and HA solutions for adhesiolysis. J Invest Surg 1995;8:337–348.

    Article  CAS  PubMed  Google Scholar 

  10. Burns JW, Colt MJ, Burgess LS, Skinner KC. Preclinical evaluation of Seprafilm™ bioresorbable membrane. Eur J Surg 1997;577Suppl:40–48.

    Google Scholar 

  11. Becker JM, Dayton MT, Fazio VW, et al. Prevention of postoperative abdominal adhesions by a sodium hyaluronate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Coll Surg 1996;183:406–407.

    Google Scholar 

  12. Diamond MP. Reduction of adhesion after uterine myomectomy by Seprafilm membrane (HAL-F): a blinded, prospective, randomized, multicenter clinical study. Seprafilm Adhesion Study Group. Fertil Steril 1996;66:904–910.

    Article  CAS  PubMed  Google Scholar 

  13. Kalayci D, Fukuchi T, Edelman PG, et al. Hydrogel tissue adhesive for sealing corneal incisions. Ophthalmic Res 2003;35:173–176.

    Article  PubMed  Google Scholar 

  14. Heuer DK, Parrish RK, Gressel MG, et al. 5-Fluorouracil and glaucoma filtering surgery. II. A pilot study. Ophthalmology 1984;91:384–394.

    Article  CAS  PubMed  Google Scholar 

  15. Heuer DK, Parrish RK, Gressel MG, et al. 5-Fluorouracil and glaucoma filtering surgery. III. Intermediate follow-up of a pilot study. Ophthalmology 1986;93:1537–1546.

    Article  CAS  PubMed  Google Scholar 

  16. Rockwood EJ, Parrish RK, Heuer DK, et al. Glaucoma filtering surgery with 5-fluorouracil. Ophthalmology 1987;94:1071–1078.

    Article  CAS  PubMed  Google Scholar 

  17. Kitazawa Y, Taniguchi T, Nakano Y Shirato S, Yamamoto T. 5-Fluorouracil for trabeculectomy in glaucoma. Graefes Arch Clin Exp Ophthalmol 1987;225:403–405.

    Article  CAS  PubMed  Google Scholar 

  18. Katz GJ, Higginbotham EJ, Lichter PR, et al. Mitomycin C versus 5-fluorouracil in high-risk glaucoma filtering surgery: extended follow-up. Ophthalmology 1995;102:1263–1269.

    Article  CAS  PubMed  Google Scholar 

  19. Meqevand GS, Salmon JF, Scholtz RP, Murray AD. The effect of reducing the exposure time of mitomycin C in glaucoma filtering surgery. Ophthalmology 1995;102:84–90.

    Article  Google Scholar 

  20. Robin AL, Ramakrishnan R, Krishnadas R, Smith SD, et al. A long-term dose-response study of mitomycin in glaucoma filtration surgery. Arch Ophthalmol 1997;115:969–974.

    Article  CAS  PubMed  Google Scholar 

  21. Mead AL, Wong TTL, Cordeiro MF, Anderson IK, Khaw PT. Evaluation of anti-TGF-β2 antibody as a new postoperative antiscarring agent in glaucoma surgery. Invest Ophthalmol Vis Sci 2003;44:3394–3401.

    Article  PubMed  Google Scholar 

  22. Mietz H, Krieglstein GK. Suramin to enhance glaucoma filtering procedures: a clinical comparison with mitomycin. Ophthalmic Surg Lasers 2001;32:358–369.

    CAS  PubMed  Google Scholar 

  23. Wong HT, Seah SK. Argumentation of filtering blebs with perfluoropropane gas bubble: an experimental and pilot clinical study. Ophthalmology 1999;106:545–549.

    Article  CAS  PubMed  Google Scholar 

  24. Demir T, Turgut B, Akyol N, et al. Effects of amniotic membrane transplantation and mitomycin C on wound healing in experimental glaucoma surgery. Ophthalmologica 2002;216:438–442.

    Article  PubMed  Google Scholar 

  25. Miller MH, Rice NS. Trabeculectomy combined with beta irradiation for congenital glaucoma. Br J Ophthalmol 1991;75:584–590.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Chen HS, Ritch R, Krupin T, Hsu WC. Control of filtering bleb structure through tissue bioengineering: an animal model. Invest Ophthalmol Vis Sci 2006;47:5310–5314.

    Article  PubMed  Google Scholar 

  27. Shoji N, Shimizu K, Takahashi K, et al. The application of crosslinked hyaluronate hydrogel to trabeculectomy. J Jpn Ophthalmol Soc 2004;108:277–282.

    Google Scholar 

  28. Özkan SB, Kir E, Culhaci Nil, Dayanir V. The effect of Seprafilm on adhesions in strabismus surgery-an experimental study. J AAPOS 2004;8:46–49.

    Article  PubMed  Google Scholar 

  29. Sueda J, Sakuma T, Nakamura H, et al. In vivo and in vitro feasibility studies of intraocular use of Seprafilm to close retinal breaks in bovine and rabbit eyes. Invest Ophthalmol Vis Sci 2006;47:1142–1148.

    Article  PubMed  Google Scholar 

  30. Miller MH, Grierson I, Unger WI, et al. Wound healing in an animal model of glaucoma fistulizing surgery in the rabbit. Ophthalmic Surg 1989;20:350–357.

    CAS  PubMed  Google Scholar 

  31. Desjardings DC, Parrish RK, Folberg R, Nevarez J, Heuer DK, Gressel MG. Wound healing after filtering surgery in owl monkeys. Arch Ophthalmol 1986;104:1835–1839.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Kurume University School of Medicine, Kurume, Fukuoka, Japan

    Naoshi Tsurumaru, Mikki Arai, Kenichi Teruya, Jun Sueda & Ryoji Yamakawa

Authors
  1. Naoshi Tsurumaru
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mikki Arai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kenichi Teruya
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jun Sueda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ryoji Yamakawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Naoshi Tsurumaru.

About this article

Cite this article

Tsurumaru, N., Arai, M., Teruya, K. et al. Seprafilm as a new antifibrotic agent following trabeculectomy in rabbit eyes. Jpn J Ophthalmol 53, 164–170 (2009). https://doi.org/10.1007/s10384-008-0638-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-008-0638-3

Key Words

Search

Navigation