Abstract
BackgroundTo investigate the effects of small incision lenticule extraction (SMILE)-derived decellularized lenticules on intraocular pressure (IOP) and conjunctival scarring in a rabbit model of glaucoma filtration surgery.MethodsTrabeculectomy was performed on both eyes of New Zealand rabbits. A decellularized lenticule was placed in the subconjunctival space in one eye of the rabbits (the decellularized lenticule group), and no adjunctive treatment was performed in the fellow eye (the control group). The filtering bleb features and IOP were evaluated 0, 3, 7, 14, 21, and 28 days after surgery, and histopathologic examination was performed 28 days after surgery.ResultsDecellularized lenticules significantly increased bleb survival and decreased IOP postoperatively in the rabbit model with no adverse side effects. The histopathologic results showed a larger subconjunctival space and less subconjunctival fibrosis in the decellularized lenticule group.ConclusionsDecellularized lenticules can prevent postoperative conjunctiva-sclera adhesion and fibrosis, and they may represent a novel antifibrotic agent for trabeculectomy.
Highlights
To investigate the effects of small incision lenticule extraction (SMILE)-derived decellularized lenticules on intraocular pressure (IOP) and conjunctival scarring in a rabbit model of glaucoma filtration surgery
Filtering blebs were maintained over the scleral flap in the decellularized lenticule group for at least 28 days, whereas the filtering blebs collapsed within 14 days after surgery in the control group
The bleb scores were significantly higher in the decellularized lenticule group than in the control group on day 3 and from day 14 to day 28 (P < 0.05, Fig. 2)
Summary
To investigate the effects of small incision lenticule extraction (SMILE)-derived decellularized lenticules on intraocular pressure (IOP) and conjunctival scarring in a rabbit model of glaucoma filtration surgery. Results: Decellularized lenticules significantly increased bleb survival and decreased IOP postoperatively in the rabbit model with no adverse side effects. Trabeculectomy, in which a drainage bypass is created to allow excess aqueous humour to drain into a conjunctival filtering bleb, is one of the most effective glaucoma filtration surgeries for reducing IOP [2]. 5-fluorouracil (5-FU) are often used during trabeculectomy surgery and have been shown to improve the surgical outcome [4, 5] These antimetabolic agents may lead to serious postoperative complications, such as persistent postoperative hypotony, corneal toxicity, filtering bleb leakage, blebitis, and endophthalmitis [4, 5]. A more physiological approach to suppressing subconjunctival fibrosis is needed
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