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In Vitro and In Vivo Studies

Nurettin Sahiner, MS, PhD; Daniel J. Kravitz, MD; Rabah Qadir, MD; Diane A. Blake, PhD; Salima Haque, MD; Vijay T. John, DEngSc; Curtis E. Margo, MD, MPH; Ramesh S. Ayyala, MD, FRCS, FRCOphth

Arch Ophthalmol. 2009;127(4):448-453.

Objective  To create and test a slow-release antifibrotic drug-coated glaucoma drainage device using in vitro and in vivo experiments.

Methods  A slow-release device incorporating mitomycin C in poly(2-hydroxyethyl methacrylate) disks was developed using redox-polymerization techniques. A standardized preparation of this drug delivery device was attached to the Ahmed glaucoma valve (model FP7; New World Medical, Inc, Rancho Cucamonga, California). Semicircular disks (5 x 6 mm) of P(HEMA)-mitomycin C containing varying concentrations of mitomycin C per gram dry weight of the gel were attached to the lower half of an Ahmed glaucoma valve plate. Water was pumped through the modified Ahmed glaucoma valve at a rate comparable to that of aqueous humor outflow, and mitomycin C release was measured. Modified and unmodified Ahmed glaucoma valves were implanted in a rabbit model, and drug release and fibrosis were assessed after 3 months.

Results  The P(HEMA)-mitomycin C device released mitomycin C in vitro over 1 to 2 weeks. Studies in rabbits revealed that mitomycin C was released from the disks during the 3-month implantation. Histologic analysis demonstrated a significant reduction in inflammatory reaction and fibrosis in the resulting blebs.

Conclusion  Our slow-release drug-coated glaucoma drainage device decreased fibrosis and inflammation in the resulting bleb in a rabbit model.

Clinical Relevance  This device could reduce the failure rate of glaucoma drainage devices.

Author Affiliations: Faculty of Science, Chemistry Department, Canakkale Onsekiz Mart University, Terzioglu Campus, Canakkale, Turkey (Dr Sahiner); Departments of Ophthalmology (Drs Kravitz, Qadir, Margo, and Ayyala), Biochemistry (Dr Blake), and Pathology (Dr Haque), Tulane University School of Medicine, and Department of Chemical and Biomolecular Engineering, Tulane University (Dr John), New Orleans, Louisiana.

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