Evaluation of sustained release of PLC-loaded prednisolone acetate microfilm on postoperative inflammation in an experimental model of glaucoma filtration surgery.
OBJECTIVE
To evaluate the effect of a biodegradable microfilm with sustained release of prednisolone acetate (PA) on postoperative wound healing after experimental glaucoma filtration surgery (GFS).


METHODS
Biodegradable microfilms composed of poly (D-, L-lactide-co-caprolactone) (PLC) were fabricated and then pre-loaded PA-20% total weight. Fourteen New Zealand White rabbits were randomly divided into 3 treatment groups: GFS alone (n=4), GFS with PLC microfilms (n=4) and GFS with PA-loaded microfilm (n=6). Microfilms were inserted subconjunctivally, adjacent to the filtering surgical site. We monitored all eyes with slit-lamp examination, bleb photography and anterior segment optical coherence tomography (AS-OCT). Histology with immunohistochemistry was performed to determine the presence of any inflammation.


RESULTS
Prednisolone acetate 20%-loaded microfilms exhibited steady, sustained release in vitro. Eyes implanted with PA-loaded microfilms showed a significantly better bleb survival (100% vs. 37.5%, p<0.001) and reduced bleb vascularity (58%; 95% CI 54-62% vs. 30%; 95% CI 23-37%, p=0.001) compared to the control at 30 days postoperatively. Histology and immunohistochemistry demonstrated less T-cell infiltration in the eye implanted with PA-loaded microfilms.


CONCLUSIONS
Subconjunctival insertion of a PA-loaded biodegradeable microfilm exhibit sustained release of PA to reduce postoperative inflammation and prolong bleb survival in rabbit GFS.
Singapore National Eye Centre, Singapore.
Marcus
M
Ang
Peng
P
Yan
Ma
M
Zhen
Selin
S
Foo
Subbu S
SS
Venkatraman
Tina T
TT
Wong
D000818:Animals; D003692:Delayed-Action Preparations; D004195:Disease Models, Animal; D004337:Drug Carriers; D009877:Endophthalmitis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D018463:Filtering Surgery; D005901:Glaucoma / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D007429:Intraocular Pressure; D019344:Lactic Acid / Q000494:pharmacology*; D011100:Polyglycolic Acid / Q000494:pharmacology*; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011183:Postoperative Complications / Q000517:prevention & control; D011239:Prednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011817:Rabbits; D041623:Tomography, Optical Coherence; D014945:Wound Healing / Q000187:drug effects
D003692:Delayed-Action Preparations; D004337:Drug Carriers; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; C009935:prednisolone acetate; D011239:Prednisolone