Effects of an anti-transforming growth factor-β agent (pirfenidone) on strabismus surgery in rabbits.
OBJECTIVE
To evaluate the usefulness of an anti-transforming growth factor-β (TGF-β) agent, pirfenidone (PFD) on postoperative inflammation and fibrosis following strabismus surgery in rabbits.


METHODS
Both eyes of 16 New Zealand white rabbits underwent reinsertion of the superior rectus muscle (SRM). After reinsertion of the SRM, PFD-loaded liposomes (0.5 mg/ml) were injected into the right eye (PFD group) and normal saline-loaded liposomes was injected into the left eye (control group), subconjunctivally (0.4 ml). To assess the postoperative inflammatory changes and fibrosis of the SRM, immunofluorescence staining with anti-CD11b antibody was performed at 3 days postoperatively, and Masson's trichrome staining was performed at 4 weeks postoperatively. To evaluate the toxicity of PFD on muscle fibers, the integrity of the muscle fibers was examined by transmission electron microscopy (TEM) at 3 days and 4 weeks postoperatively.


RESULTS
CD11b protein expression was significantly reduced in the PFD group compared with the control group at 3 days postoperatively (p = 0.012). Masson trichrome staining, which stains collagen, was diminished in the PFD group at 4 weeks postoperatively. TEM revealed disorganized muscle fibers and vacuoles in both groups, but this was less prominent in the PFD group.


CONCLUSIONS
Intraoperative injection of PFD may be effective as an adjunctive treatment to decrease inflammation and fibrosis resulting from strabismus surgery.
Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea ,  Seoul ,  Korea.
Kyoung In
KI
Jung
Jun-Sub
JS
Choi
Hyun Kyung
HK
Kim
Sun Young
SY
Shin
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D007249:Inflammation / Q000517:prevention & control; D009801:Oculomotor Muscles / Q000187:drug effects* / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D011728:Pyridones / Q000494:pharmacology*; D011817:Rabbits; D013285:Strabismus / Q000601:surgery*; D016212:Transforming Growth Factor beta / Q000037:antagonists & inhibitors; D014945:Wound Healing / Q000187:drug effects*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D011728:Pyridones; D016212:Transforming Growth Factor beta; C093844:pirfenidone