Br J Ophthalmol 1998;82:816-820 ( July )
Suramin inhibits wound healing following filtering procedures for
glaucoma
Holger Mietz,a b
Patricia Chévez-Barrios,a b
Robert M Feldman,c
Michael W Liebermanb
a Department of
Pathology, Baylor College of Medicine, Houston, Texas, USA, b Department of
Ophthalmology, Baylor College of Medicine, Houston, Texas, c Department of Ophthalmology and Visual Science,
University of Texas Medical School at Houston, Texas
Correspondence to: Dr H Mietz, Department of
Ophthalmology, University of Cologne, Germany.
; Accepted for publication 11 February 1998
BACKGROUND Trabeculectomies
are the most frequently performed procedures in surgically treating
eyes with glaucoma. Failures are caused by fibrosis in the external
ostium of the filtering procedure. In order to inhibit the fibrotic
wound healing reaction, a new pharmacological approach using suramin,
which inhibits a variety of important growth factors was used.
METHODSPigmented
rabbits were used and filtering procedures performed. Suramin was
applied with concentrations ranging from 10 mg/ml to 333 mg/ml once
during surgery and four times following surgery. The success of the
filtering procedure was assessed by intraocular pressure measurements.
To evaluate possible intraocular toxic effects, treated eyes were
histopathologically evaluated after 4 weeks, and the ciliary body
adjacent to the site of application was examined using electron microscopy.
RESULTSWith
concentrations of suramin of 200 mg/ml and 333 mg/ml, the
trabeculectomies were patent longer than in the controls and in eyes
operated with mitomycin C, which currently is the most frequently used
antiproliferative drug to enhance the outcome of surgery in humans. No
severe toxic effects to the ciliary epithelium were seen in suramin
treated eyes.
CONCLUSIONSThis study
demonstrates for the first time the efficiency of a substance that
broadly inhibits the action of growth factors on target cells in the
setting of ocular wound healing. In this in vivo model, suramin has
been shown to be highly effective in preventing scarring and in having
fewer toxic side effects than usually used antimetabolites. These
results therefore may suggest a new approach to the surgical treatment
of glaucoma.
Keywords:
glaucoma;
wound healing;
suramin;
trabeculectomy;
rabbits
© 1998 by British Journal of Ophthalmology
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