TY - JOUR
T1 - The inflammatory and foreign body reaction of polymethyl methacrylate glaucoma drainage device in the rabbit eye
AU - Oktariana Asrory, Virna D.
AU - Sitompul, Ratna
AU - Artini, Widya
AU - Estuningsih, Sri
AU - Noviana, Deni
AU - Morgan, William H.
PY - 2020
Y1 - 2020
N2 - Purpose: To assess the safety and tissue response of a polymethyl methacrylate (PMMA) glaucoma drainage device (GDD) in the rabbit eye. Methods: Specially constructed PMMA GDD devices were implanted into rabbit eyes and evaluated histopathologically following euthanasia on days 5, 30, and 60 after implantation surgery. Hematoxylin-eosin, Masson’s trichrome, and periodic acid-Schiff were used to stain tissue specimens dissected from the surgical site. Inflammatory cell count and capsule thickness measurements were performed. Results: Three rabbits were sacrificed on day 5, 3 on day 30, and 4 on day 60. Macrophage and lymphocyte counts increased from day 5 to day 30 then decreased (P = 0.0000) with greater counts seen in the superior regions. At day 30, a fibrous capsule had formed around the plate area. Fibroblast counts increased significantly between day 5 to day 30 and again to day 60 (P = 0.001) with greatest numbers anteriorly. The inferior capsule thickness at day 60 was 243 μm (standard deviation, 120; 95% confidence interval: 53-433). The superior capsule thickness was 388 μm (standard deviation, 136; 95% confidence interval: 172-604). No adverse reactions were seen. Conclusions: Histopathologically, the inflammatory response toward this PMMA glaucoma drainage device was comparable to other reported GDDs. No accentuated response or adverse event was seen suggesting that PMMA may be useful as a GDD material. Translational Relevance: An affordable, locally built GDD is needed in Indonesia because of the high prevalence of severe glaucoma. This rabbit study is a significant step toward justifying the use of PMMA as a GDD material. PMMA is cheap and easily manufactured and sterilized in developing economies.
AB - Purpose: To assess the safety and tissue response of a polymethyl methacrylate (PMMA) glaucoma drainage device (GDD) in the rabbit eye. Methods: Specially constructed PMMA GDD devices were implanted into rabbit eyes and evaluated histopathologically following euthanasia on days 5, 30, and 60 after implantation surgery. Hematoxylin-eosin, Masson’s trichrome, and periodic acid-Schiff were used to stain tissue specimens dissected from the surgical site. Inflammatory cell count and capsule thickness measurements were performed. Results: Three rabbits were sacrificed on day 5, 3 on day 30, and 4 on day 60. Macrophage and lymphocyte counts increased from day 5 to day 30 then decreased (P = 0.0000) with greater counts seen in the superior regions. At day 30, a fibrous capsule had formed around the plate area. Fibroblast counts increased significantly between day 5 to day 30 and again to day 60 (P = 0.001) with greatest numbers anteriorly. The inferior capsule thickness at day 60 was 243 μm (standard deviation, 120; 95% confidence interval: 53-433). The superior capsule thickness was 388 μm (standard deviation, 136; 95% confidence interval: 172-604). No adverse reactions were seen. Conclusions: Histopathologically, the inflammatory response toward this PMMA glaucoma drainage device was comparable to other reported GDDs. No accentuated response or adverse event was seen suggesting that PMMA may be useful as a GDD material. Translational Relevance: An affordable, locally built GDD is needed in Indonesia because of the high prevalence of severe glaucoma. This rabbit study is a significant step toward justifying the use of PMMA as a GDD material. PMMA is cheap and easily manufactured and sterilized in developing economies.
KW - Foreign body reaction
KW - Glaucoma drainage device
KW - Inflammatory reaction
KW - Polymethyl methacrylate
UR - http://www.scopus.com/inward/record.url?scp=85081119958&partnerID=8YFLogxK
U2 - 10.1167/tvst.9.3.20
DO - 10.1167/tvst.9.3.20
M3 - Article
C2 - 32714646
AN - SCOPUS:85081119958
SN - 2164-2591
VL - 9
JO - Translational Vision Science and Technology
JF - Translational Vision Science and Technology
IS - 3
M1 - 20
ER -