Journal of Current Glaucoma Practice

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VOLUME 8 , ISSUE 2 ( May-August, 2014 ) > List of Articles

REVIEW ARTICLE

Wound Healing Modulation in Glaucoma Filtration Surgery–Conventional Practices and New Perspectives: The Role of Antifibrotic Agents (Part I)

Jennifer C Fan Gaskin, Dan Q Nguyen, Ghee Soon Ang, Jeremy O'Connor, Jonathan G Crowston

Keywords : Glaucoma, Trabeculectomy, Filtration surgery, Antimetabolites, Wound healing modulation, Scarring

Citation Information : Fan Gaskin JC, Nguyen DQ, Soon Ang G, O'Connor J, Crowston JG. Wound Healing Modulation in Glaucoma Filtration Surgery–Conventional Practices and New Perspectives: The Role of Antifibrotic Agents (Part I). J Curr Glaucoma Pract 2014; 8 (2):37-45.

DOI: 10.5005/jp-journals-10008-1159

License: CC BY-NC 4.0

Published Online: 01-08-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Glaucoma filtration surgery is regularly performed for the treatment of glaucoma and trabeculectomy is often regarded as the ‘gold standard’ glaucoma operation. The biggest risk of failure of the operation is bleb scarring. The advent of anti-fibrotic agents, such as mitomycin C (MMC) and 5-fluorouracil (5FU) has vastly prolonged the longevity of the bleb, but concerns remain regarding the potential increase in postoperative complications. More selective therapeutic targets have therefore been explored. One of these is vascular endothelial growth factor (VEGF) inhibition. Vascular endothelial growth factor inhi bition has a role not only in sub conjunctival angiogenesis inhi bition but also it has direct anti-fibrotic properties. Newer phar macological compounds and materials have also been developed in recent years in attempt to modulate the wound healing in different ways after glaucoma surgery. These include physical barriers to scarring and vehicles for sustained release of pharmacological agents, and early promising results have been demonstrated. This two-part review will provide a discussion of the application of anti-fibrotic agents in glaucoma filtration surgery and evaluate the newer agents that have been developed.


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