P 319 Immunohistochemical assessment of fibroblastic proliferation after glaucoma surgery with antimetabolites

EFFECTfVENESS OF DIODE LASEl? VERSUS FILTERING SURGERY WITH MITOMYCINC INAN BXPERIMENTAL MODEL PABLO L, PUEYO M. GOMQ ML, RONCHERA J, SANCHEZ A. RAMIRR T? HONRUBIA FM. Department ofOphIhalmo4ogy. ‘Miguel Servet’ Hospnal. Zaragoza. Spain ‘Dopadmant of Path-y m Both flitedog sutgery wiih Mtomydn-C (MMC) and laser diode cyclophotocoagulation have pmved 10 be effective alternatives in cases of ~lauwma wiIh poor surgical prognosis. The aim Oi ihis study is lo compare the effidency and reliabilky of both lherapeutic techniques in an experimental l”cdel. Hypothesis: The apdlcalion of a 2.7 mJ dose of semlcondudor laser diode k&$&s ifltmocular pkra al lhe same level as the one obtained with an awlication of 0.4 moJml. of MMC In ao experimental model of filtering sirgery IO rabbits. &&f#&& The rioht eyes of 42 plomentcd rabbits ware randomly divided in 2 omuw: Teh MMC Dmup undement Rlterlm sumery with applicalion of 0.4 -qjrnl. of MMC wham& lhe DL omup mc&dl5~laser a$ications of 2.7 mJ (2700 mW.1000 ms.1 disb’lboted in 270 l . The parameter studied in the 2 Ill&lhs that followed the operauons included inb&cular pressure. tyndall. hvoetemfa and hlphema. Tiie rtstlruul tiy was perfomled osln&l Mann-Whitney test, Kaplan-Meier CU~VBI snd Lograok test. A level of pcO.05 was regarded ss significant for all analyses. m w?lm CoobaNlng lha IOP means. m obsawe wnspiwous dlffereoces between days 4 and 10 wilh a hbher IOP lowering in the DL omuo. survival curves also revealed outstandim differences (~=0.017851) ii th6 Logmnk test belween DL and MMC gmu& Ocular hymermlon. hlphemas. and inflammatory madion were all higher in the DL omup shorily aftorwlrds as wall as In (he lono mn COnCluslOM: Ws musl point out tba lhe trwbnenl wilh laser has pmved to be mom effeclive allhoogh both tmatmeol show very acceptable IOP lowsrl~ uolll2 0’0nlhs following the surgery. Oo the other hand. the use of ImOr techrow with humans most be carsfully considered owing 10 Ihe &23ibk appearsma of tewiowl peaks in wdy dage.9 after surwy This sludy has been supported by a gmnt of the Spanish Govemmenl. PCM 2993 CCNAI. EFFECTS OF MITOMYCINC IN WOUND HEALING. ULTRAESTRUCTURAL FINDINGS RAMIREZ T’, PABLO L, ASECIA E, ALVAREZ R’, POLO V. ROJO A, PUEYO M, HONRUBIA FM. Depadment of Ophthalmology. 1 Department of Pathology. “Miguel Serf& Hospital. Zaragoza (Spain) m Failure of DlaiKxXIIa Rlteflno sumery is related lo excessive wound healing in sorgim) area. The use of hiito&dri-C (MMC) dacmses the number of cells present In the area sod locmases lhe socoess rate In animal and human a+. We used 8” experImental model of glauaxna filtering surgery to evaluate and compare the uHmsludoml effects of a single intraoperalive aDDliwuon Of MMC. &&&z 60th eyes of forty pigmented mbbits wem operated (non-pmtecuve fiherln~ sumery). One eye of each rabbit was randomly selecled to receive a 0.4 m&l solution of t&C, whemas the fellow aye & treated with balanced saline solution (BBS) as placebo. Ten animals wBm killed on days 4,6.15.30 and SO. Once the animals has been sacxified, the eyes wem carefully removed, Sedioos wBm cut on a Reiched Jung ultmmicotome and vlewed In a JEOL 10oc lrawmission eledmn mkxcscope. &!&z In early stagas all the MMGlmatsd eyes showed some degree of decmased adlvity. The Rbmblasl cylo@asm was atmosl depleted of c.?llular organeller The densw of scar tissue was lower and *owed Inegulariy arranged collagen bundles. Treated eyes showed less vasculadzation. On day 30 MMC-treated eyes showed some degree of decreased activity compared with placebo trated eyes. Collagen flbers wem less oriented In the MMC-traatsd ens. On day 60 both omups showed a decreased number of fibmblasls and a similar degree of adivky in thelr orgaoelles. Co clusion2z The inhibitory effed of MMC on vascular ~rowlh could play a p&mderant mle In the lnterropllon of wound herllng pmcess. The new blood capillades would involve the anlval of new fibmblasl that migth cause a delayed fistural clousure. Thkly days after surgery the presence of moderately adve fltmblasl In some MMC-treated eyes mi@h lndlcate a possible capacity of pmllfemtion In a late stage of growlh. New studies could bs useful to detennlnate whether new dosages of antimetabplite should applied at the adewate post-operative time.