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Part 2

Ramesh S. Ayyala, MD, FRCS, FRCOphth; B. Michelini-Norris, PhD; Ana Flores, MD; Edward Haller; Curtis E. Margo, MD, MPH

Arch Ophthalmol. 2000;118:1081-1084.

Background  Inflammation associated with biomaterials may contribute to the failure of glaucoma drainage devices.

Objective  To compare the inflammatory reaction associated with the insertion of Krupin silicone, Molteno polypropylene, and Acrosof end plates in the subconjunctival space of rabbits.

Methods  Similar-sized glaucoma end plates made of 3 different biomaterials were sutured to the sclera in the superotemporal quadrant of the rabbit eye. Thirty eyes of 15 albino New Zealand rabbits were randomly assigned to the 3 groups. Conjunctival vascular hyperemia was graded in a masked fashion among the 3 groups. At the end of 3 weeks, the enucleated eyes were examined histologically and by scanning electron microscopy.

Results  Molteno polypropylene was associated with more inflammation both in clinical observations and based on histological grading. Silicone and Acrosof were associated with less intense inflammation. One polypropylene end plate was extruded on day 21.

Conclusions  Polypropylene appears to be more inflammatory than silicone. Flexible biomaterials appear to be less inflammatory than rigid ones.

Clinical Relevance  Bleb failure following glaucoma drainage device implantation could be related to the biomaterial-associated inflammation. Choosing a biomaterial with the least inflammatory potential might enhance the success rate of the glaucoma drainage device.

From the Departments of Ophthalmology, Tulane University Medical Center, School of Medicine, New Orleans, La, and Medical Center of Louisiana at New Orleans (Dr Ayyala); Departments of Ophthalmology (Drs Michelini-Norris and Flores) and Pathology (Dr Haller), University of South Florida, Tampa, and Department of Ophthalmology, Watson Clinic, Lakeland, Fla (Dr Margo).

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