Wound Healing Modulation in Glaucoma Filtration Surgery-Conventional Practices and New Perspectives: The Role of Antifibrotic Agents (Part I)
- PMID: 26997807
- PMCID: PMC4741165
- DOI: 10.5005/jp-journals-10008-1159
Wound Healing Modulation in Glaucoma Filtration Surgery-Conventional Practices and New Perspectives: The Role of Antifibrotic Agents (Part I)
Abstract
Glaucoma filtration surgery is regularly performed for the treatment of glaucoma and trabeculectomy is often regarded as the 'gold standard' glaucoma operation. The biggest risk of failure of the operation is bleb scarring. The advent of anti-fibrotic agents, such as mitomycin C (MMC) and 5-fluorouracil (5FU) has vastly prolonged the longevity of the bleb, but concerns remain regarding the potential increase in postoperative complications. More selective therapeutic targets have therefore been explored. One of these is vascular endothelial growth factor (VEGF) inhibition. Vascular endothelial growth factor inhi bition has a role not only in sub conjunctival angiogenesis inhi bition but also it has direct anti-fibrotic properties. Newer phar macological compounds and materials have also been developed in recent years in attempt to modulate the wound healing in different ways after glaucoma surgery. These include physical barriers to scarring and vehicles for sustained release of pharmacological agents, and early promising results have been demonstrated. This two-part review will provide a discussion of the application of anti-fibrotic agents in glaucoma filtration surgery and evaluate the newer agents that have been developed. How to cite this article: Fan Gaskin JC, Nguyen DQ, Ang GS, O'Connor J, Crowston JG. Wound Healing Modulation in Glaucoma Filtration Surgery-Conventional Practices and New Pers pectives: The Role of Antifibrotic Agents (Part I). J Curr Glaucoma Pract 2014;8(2):37-45.
Keywords: Antimetabolites; Filtration surgery; Glaucoma; Scarring.; Trabeculectomy; Wound healing modulation.
Conflict of interest statement
References
-
- Chen CW. Enhanced int raocular pressure cont rolling ef fective ness of trabeculectomy by local application of mitomycin C. Trans Asia-Pacific Acad Ophthalmol. 1983;9:172–177.
-
- Gressel MG, Parrish RK 2nd, Folberg R. 5-fluorouracil and glaucoma filtering surgery: I. An animal model. Ophthal mology. 1984 Apr;91(4):378–383. - PubMed
-
- Skuta GL, Parrish RK 2nd. Wound healing in glaucoma filtering surgery. Surv Ophthalmol. 1987 Nov-Dec;32(3):149–170. - PubMed
-
- Loon SC, Chew PT. A major review of antimetabolites in glaucoma therapy. Ophthalmologica. 1999;213(4):234–245. - PubMed
Publication types
LinkOut - more resources
Full Text Sources
Other Literature Sources
Miscellaneous