The effectiveness of colchicine combined with mitomycin C to prolong bleb function in trabeculectomy in rabbits.

Taiki Kokubun,Kota Sato,Takahiro Akaishi,Kazuko Omodaka,Toru Nakazawa,Masatsugu Nakamura,Kotaro Yamamoto,Yukihiro Shiga,Atsushi Shimazaki,Satoru Tsuda,Demetrios G Vavvas

doi:10.1371/journal.pone.0213811

Abstract

PurposeTo investigate the potential of colchicine to improve bleb function after trabeculectomy.MethodsTo find the maximum usable colchicine concentration, an ocular irritation study was performed with the Draize test at concentrations of 0.001%, 0.01% and 0.1%. Additionally, the synergistic effect of topical colchicine instillation and MMC application to surgical site was evaluated in a rabbit model by measuring changes after trabeculectomy in intraocular pressure (IOP) and bleb morphology score at 3, 7, 14, 21, 28, 35, 42, and 49 days.ResultsExperiments with a rabbit model of trabeculectomy showed that 0.04% MMC plus 0.01% colchicine was more effective than saline and 0.04% MMC alone in maintaining IOP reduction at days 7–49 (P < 0.01 at all time points) and day 49 (P < 0.05), respectively, while 0.04% MMC alone was more effective than saline only at days 7–35 (P < 0.05 at all time points). 0.04% MMC plus 0.01% colchicine and 0.04% MMC alone were more effective than saline at preserving bleb score at days 7–21 and 35–49 (P < 0.05 at all time points) and at days 7–35 (P < 0.05 at all time points), respectively.ConclusionColchicine may be a promising adjuvant for strengthening the effect of MMC and improving the survival of the filtering bleb in trabeculectomy.

Highlights

Trabeculectomy is one of the most common types of filtration surgery to reduce intraocular pressure (IOP) in glaucoma[1]
Experiments with a rabbit model of trabeculectomy showed that 0.04% mitomycin C (MMC) plus 0.01% colchicine was more effective than saline and 0.04% MMC alone in maintaining IOP reduction at days 7–49 (P < 0.01 at all time points) and day 49 (P < 0.05), respectively, while 0.04% MMC alone was more effective than saline only at days 7–35 (P < 0.05 at all time points). 0.04% MMC plus 0.01% colchicine and 0.04% MMC alone were more effective than saline at preserving bleb score at days 7–21 and 35–49 (P < 0.05 at all time points) and at days 7–35 (P < 0.05 at all time points), respectively
Colchicine may be a promising adjuvant for strengthening the effect of MMC and improving the survival of the filtering bleb in trabeculectomy

Summary

Introduction

Trabeculectomy is one of the most common types of filtration surgery to reduce intraocular pressure (IOP) in glaucoma[1]. This technique involves creating a filtering bleb, through which aqueous humor flows from the anterior chamber into the sub-Tenon’s space and is absorbed into the bleb wall (which consists of Tenon’s tissue). The success rate is improved with the use of MMC, bleb failure still occurs in some cases due to strong fibrosis. It is important to identify safer and more broadly targeted anti-fibrotic agents that can maintain bleb function for a longer period and can be used postoperatively in addition to MMC, to help preserve the filtering bleb when it shows signs of failure

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Results

Conclusion