Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 1;30(11):1001-1010.
doi: 10.1097/IJG.0000000000001907.

Novel Bacterial Cellulose Membrane to Reduce Fibrosis Following Trabeculectomy

Serpil Yazgan  1 , Ishak Ozel Tekin  2 , Nusret Akpolat  3 , Ozhan Koc  1
Affiliations

Novel Bacterial Cellulose Membrane to Reduce Fibrosis Following Trabeculectomy

Serpil Yazgan et al. J Glaucoma. .

Abstract

Purpose: The aim was to evaluate the effectiveness of bacterial cellulose membrane (BCM) in preventing fibrosis in trabeculectomy and the biocompatibility of BCM with conjunctiva and sclera.

Materials and methods: Twenty-one eyes of 21 adult rabbits underwent fornix-based trabeculectomy. Standard surgery was done to control group (CG, n=7). Mitomycin-C (MMC) (0.3 mg/mL, 3 min) was applied to MMC group only (MMCG, n=7). BCM (~100 µm thick, 10×10 mm, single layer) was covered on the sclerotomy area before conjunctiva was closed in BCM group (BCMG, n=7). Intraocular pressures (IOP) were measured before, and 7, 14, 28, and 45 days after surgery (IOP-POD7, POD14, POD28, POD45). The IOP decrease were expressed as DIOP%-POD7, DIOP%-POD14, DIOP%-POD28, and DIOP%-POD45. The rabbits were sacrificed on the 45th day. Conjunctival vessel number, degrees of fibrosis, total inflammation, foreign body reaction, inflammatory cell types (B cells, T cells, plasma cells), macrophages, bleb spaces and the expression of α-smooth muscle actin were studied using histopathology and immunohistochemistry techniques. The groups were compared using nonparametric tests.

Results: There was no statistically significant difference between the groups regarding baseline IOP and DIOP%-POD7 (P>0.05). While DIOP%-POD14, 28 and 45 were similar between BCMG and MMCG, they were significantly lower in CG (P<0.05). The lowest conjunctival vessel number was detected in the MMCG but the difference was not significant. There was no difference between BCMG and CG with regard to the numbers of B cells, T cells, and macrophages, however, these cells were significantly lower in MMCG (P<0.05). Five cases had mild and 2 cases had moderate foreign body reaction in the BCMG. There was mild to moderate inflammation in all BCM cases. While fibrosis and α-smooth muscle actin staining were higher in the CG (P<0.001), they were minimal in the BCM and MMCGs.

Conclusions: BCM showed good biocompatibility and provided better control of IOP with minimal fibrosis at the trabeculectomy site compared with the control group.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

References

    1. Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006;90:262–267.
    1. Lavia C, Dallorto L, Maule M, et al. Minimally-invasive glaucoma surgeries (MIGS) for open angle glaucoma: a systematic review and meta-analysis. PLoS One. 2017;12:e0183142.
    1. Sheheitli H, Tirpack AR, Parrish RK II. Which patients would most likely to benefit: MIGS or MEGS, which one is it? Asia Pac J Ophthalmol (Phila). 2019;8:436–440.
    1. Pahlitzsch M, Klamann MK, Pahlitzsch ML, et al. Is there a change in the quality of life comparing the micro-invasive glaucoma surgery (MIGS) and the filtration technique trabeculectomy in glaucoma patients? Graefes Arch Clin Exp Ophthalmol. 2017;255:351–357.
    1. Bloom P, Au L. “Minimally Invasive Glaucoma Surgery (MIGS) is a poor substitute for trabeculectomy”-The Great Debate. Ophthalmol Ther. 2018;7:203–210.

Publication types

LinkOut - more resources