advertisement
Abstract #9029 Published in IGR 5-2
Photodynamic modulation of wound healing in glaucoma filtration surgery
Jordan JF; Diestelhorst M; Grisanti S; Krieglstein GKBritish Journal of Ophthalmology 2003; 87: 870-875
AIM: To report a clinical pilot study investigating photodynamic therapy (PDT) in combination with glaucoma filtration surgery. BCECF-AM was used as the photosensitizing substance. The clinical safety and tolerability of BCECF-AM, and its efficacy in controlling postoperative intraocular pressure (IOP) were assessed. METHODS: Before trabeculectomy (TE), 42 consecutive eyes of 36 glaucoma patients received one subconjunctival injection of 80 μg BCECF-AM (2,7,-bis- (2-carboxyethyl) -5- (and-6) -carboxy-fluorescein, acetoxymethyl-ester) followed by an intraoperative illumination with blue light (= 450-490 nm) for eight minutes. Antifibrotic efficacy was established as postoperative IOP reduction of > 20% and/or an IOP constantly < 21 mmHg without antiglaucomatous medication. Follow-up of the filtering bleb was documented by slit-lamp examination. RESULTS: Eyes had mean 1.1 preoperative surgical interventions (filtration and non-filtration glaucoma surgery). Mean preoperative IOP was 31.6 (SD 9.7) mmHg. Patients were followed for mean 496 days (range, 3.5-31.8 months). Of the 42 eyes, 25 eyes had an IOP decreased to 15.8 (3.4) mmHg without medication (complete success: 59.5%; p < 0.001; t test). Seven eyes showed good IOP reduction < 21 mmHg under topical antiglaucomatous medication (qualified success: 16.7%). Ten eyes failed because of scarring within two to 67 weeks (23.8%). Clinical follow-up examinations revealed no local toxicity, no uveitis, and no endophthalmitis. CONCLUSIONS: This method is a new approach in modulating postoperative wound healing in human eyes undergoing glaucoma filtration surgery. The data from the first human eyes combining TE with PDT underline the clinical safety of this method and its possible potential to prolong bleb survival.
Dr. Jens F Jordan, University Eye Hospital, Joseph-Stelzmann-Strasse 9, 50931 Cologne, Germany. j.jordan@uni-koeln.de
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
