Analysis of the impact of different schemes of preparation to trabeculectomy on the healing markers using in vitro model of the Tenon fibroblast cultures isolated directly from the patient

Abstract

Aims/Purpose: The aim of the study was to assess the influence of different regimes of patient's preparation before trabeculectomy on the markers of healing process in Tenon's fibroblast cultures.Methods: The studied group consisted of 66 patients with open angle glaucoma undergoing primary trabeculectomy. The patients were divided into 5 groups with different regimes of preparation before the surgery based on application or withdrawal of topical antiglaucoma medications and steroids. During trabeculectomy the samples of Tenon's capsule were obtained. Tenon fibroblasts were isolated directly from the explants to test their proliferation ability and the level of released healing markers. Following factors typical of healing process were evaluated using commercially available ELISA kits: IL 1‐β, IL‐6, IL‐8, VEGF‐A, TGF‐ β1 and MMP‐9.Results: Concentrations of IL‐1β, IL‐6 and TGF‐ β1 were significantly higher in the group obtaining antiglaucoma drops. Additionally, in this group the fibroblasts revealed the highest proliferation potential, indicating the active healing process. The levels of IL‐8, VEGF‐A and MMP‐9 were similar between the groups.Conclusions: Our study shows that for the best conjunctival anti‐inflammatory control, the most influential factor is the withdrawal of antiglaucoma medications.