Grooved Glaucoma Drainage Devices That Continuously Deliver Cyclosporine A Decrease Postsurgical Scar Formation in Rabbit Eyes.
To study the functional outcomes of filtration surgery by implanting improved glaucoma drainage devices (GDDs) comprising surface grooves and a composite coating of cyclosporine A (CsA) and PLGA in experimental rabbit eyes.



Improved GDDs were designed and prepared by modifying normal GDD with surface grooves and a CsA-PLGA composite coating. Normal GDDs, grooved GDDs (G-GDDs), and G-GDDs with a CsA-PLGA composite coating (CsA@G-GDD) were implanted into 18 rabbit eyes (six eyes per group). The intraocular pressure (IOP), bleb survival time, bleb morphology, and anterior chamber reactions were assessed for up to 12 weeks after GDD implantation. The IOPs were compared statistically among the three groups. Bleb morphology was quantified using the Indiana Bleb Appearance Grading Scale. Anterior chamber radiography was performed to check whether the filtrating pathway was blocked, and determine the drainage time and diffusion area of the contrast agent. Hematoxylin and eosin staining and immunohistochemistry were conducted to assess how the GDDs slowed or prevented scar formation.



The improved GDDs were successfully prepared and implanted in 18 rabbit eyes without severe surgical complications. Bleb survival time was significantly longer and IOP was significantly lower in the G-GDD and CsA@G-GDD groups compared with the GDD group (all, P < 0.001). Blebs were significantly higher in the CsA@G-GDD group than in the GDD and G-GDD groups (P = 0.003). Anterior chamber radiography revealed more unobstructed filtration channels in the CsA@G-GDD group than in the GDD group (P = 0.032). Postsurgical scar formation was less extensive in the G-GDD and CsA@G-GDD groups than in the GDD group.



Compared with the normal GDDs, G-GDDs with a CsA-PLGA coating inhibited postsurgical scar formation and improved the surgical success rate, and might represent an alternative to existing glaucoma filtration devices.
Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China 2Key Laboratory of Myopia, NHFPC, and Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.
Zhaoxing
Z
Dai
Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China 2Key Laboratory of Myopia, NHFPC, and Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.
Xiaobo
X
Yu
Key Laboratory of Myopia, NHFPC, and Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China 3Eye Institute, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China 4State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai, China.
Jianguo
J
Sun
Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China 2Key Laboratory of Myopia, NHFPC, and Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China 5State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China.
Xinghuai
X
Sun
D000818:Animals; D065306:Corneal Injuries / Q000175:diagnosis / Q000517:prevention & control*; D016572:Cyclosporine / Q000008:administration & dosage*; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007429:Intraocular Pressure; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control*; D011474:Prosthesis Design; D011817:Rabbits; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D007166:Immunosuppressive Agents; D016572:Cyclosporine