Efficacy of intraoperative subconjunctival triamcinolone acetonide as antifibrotic agent in filtration surgery
Krishlex G. Gruezo, MD, Paolo Antonio S. Silva, MD, Patricia M. Khu, MD, MS, Rafael M. Valenzuela, MD, Yasmine C. Ronquillo, MD
Objective
This study determined the effects of administering a single dose (4 mg) of intraoperative subconjunctival triamcinolone acetonide (TA) on the activity/ proliferation of conjunctival fibroblasts in albino rabbits undergoing filtration surgery.
Methods
An experimental animal study was performed to compare the effects on filtration surgery of a single, 4-mg subconjunctival TA injection with balanced salt solution (BSS) and mitomycin-C (MMC, 0.4mg/mL).
Results
A single, 4-mg dose of intraoperative subconjunctival TA prolonged the average bleb survival to 14.7 days versus 11 days with BSS, and 19.8 days with MMC. Intraocular pressures (IOP) were all significantly reduced on the first postoperative day. Mean IOP was lower with TA than with BSS during the first week postoperatively, while IOP reduction with MMC extended beyond the tenth postoperative day. Bleb height postoperatively was not different among the groups, except on postoperative day 2 when TA had significantly higher bleb height than the other 2 groups. Mean fibroblast counts for the 3 treatment groups were not statistically different at the time of bleb failure.
Conclusion
A single, 4-mg dose of triamcinolone acetonide given subconjunctivally in rabbit eyes can delay wound healing in the early period after filtration surgery.
Keywords: Triamcinolone acetonide, Filtering bleb, Filtration surgery, Wound healing, Glaucoma