Prevention of Fibrous Changes in the Model of Ophthalmosurgical Trauma in the Treatment of Glaucoma

The process of fibrosis in the area of newly formed outflow tracts during surgical treatment of glaucoma leads to a decrease in efficiency. Today, various approaches are used to reduce postoperative scarring. In some cases, the use of certain methods, as well as their combinations, does not bring the expected result. It is proposed to evaluate the antifibrotic effect of adipose tissue autograft in an experiment. This study considers an experimental model for preventing fibrotic changes in surgical trauma during glaucoma treatment.

Objective: Development of a model and experimental clinical and morphological substantiation of the antifibrotic effect of adipose tissue autografting in the area of surgical trauma during glaucoma treatment.

Material and methods. The studies were conducted on 10 eyes of laboratory animals (5 mature rabbits). The animals underwent surgery according to the volume of traumatic impact corresponding to non-penetrating surgery. Two groups were identified: the main group — 5 eyes (the left eye of the animal) surgically treated with the introduction of a fraction of adipose tissue into the surgical area, the comparison group — 5 eyes (the right eye of the animal) without autotransplantation of adipose tissue. The observation period was 1 month. During biomicroscopy on days 1, 3, 5, 7, 10, 15 and 30 after the intervention, the characteristics of the surgical area were assessed according to the Würzburg Clinical and Morphological Classification (WBCS). After the animals were withdrawn from the experiment, histological comparison of the tissue areas of the surgical areas was performed.

Results. Comparison of the total index of the Würzburg Clinical and Morphological Classification shows that starting from the 5th day after the intervention, there is a clear distinctive dynamic between the study groups. In the group with the introduction of adipose tissue, there was minimal vascularization of the surgical area, with the original height and width of the formed cushion maintained throughout the observation period. Histological comparison confirms the absence of signs of formation of scar connective tissue in the area of operation in rabbits with autotransplantation of adipose tissue, while in the comparison group rabbits there is a pronounced tendency to scarring.

Conclusions. The experimental model demonstrates the possibility of autotransplantation of adipose tissue into the sub-Tenon space in surgical treatment of glaucoma. The justification for the antifibrotic effect is obtained based on the obtained clinical and morphological data.

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