Comparison of different biomaterials for glaucoma drainage devices: part 2.
BACKGROUND
Inflammation associated with biomaterials may contribute to the failure of glaucoma drainage devices.


OBJECTIVE
To compare the inflammatory reaction associated with the insertion of Krupin silicone, Molteno polypropylene, and Acrosof end plates in the subconjunctival space of rabbits.


METHODS
Similar-sized glaucoma end plates made of 3 different biomaterials were sutured to the sclera in the superotemporal quadrant of the rabbit eye. Thirty eyes of 15 albino New Zealand rabbits were randomly assigned to the 3 groups. Conjunctival vascular hyperemia was graded in a masked fashion among the 3 groups. At the end of 3 weeks, the enucleated eyes were examined histologically and by scanning electron microscopy.


RESULTS
Molteno polypropylene was associated with more inflammation both in clinical observations and based on histological grading. Silicone and Acrosof were associated with less intense inflammation. One polypropylene end plate was extruded on day 21.


CONCLUSIONS
Polypropylene appears to be more inflammatory than silicone. Flexible biomaterials appear to be less inflammatory than rigid ones.


CONCLUSIONS
Bleb failure following glaucoma drainage device implantation could be related to the biomaterial-associated inflammation. Choosing a biomaterial with the least inflammatory potential might enhance the success rate of the glaucoma drainage device. Arch Ophthalmol. 2000;118:1081-1084
Department of Ophthalmology, Tulane University Medical Center, New Orleans, LA 70112 USA. rsayyala@hotmail.com.
R S
RS
Ayyala
B
B
Michelini-Norris
A
A
Flores
E
E
Haller
C E
CE
Margo
D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects*; D003228:Conjunctiva / Q000098:blood supply; D005549:Foreign-Body Reaction / Q000209:etiology* / Q000473:pathology; D005901:Glaucoma / Q000601:surgery; D006940:Hyperemia / Q000209:etiology* / Q000473:pathology; D008855:Microscopy, Electron, Scanning; D018465:Molteno Implants / Q000009:adverse effects*; D019904:Polymethyl Methacrylate / Q000009:adverse effects; D011126:Polypropylenes / Q000009:adverse effects; D011475:Prosthesis Failure; D011817:Rabbits; D012590:Sclera / Q000601:surgery; D012826:Silicone Elastomers / Q000009:adverse effects
D001672:Biocompatible Materials; D011126:Polypropylenes; D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate