Effects of infliximab, sirolimus and sunitinib on wound healing in experimental glaucoma filtering surgery and comparison with mitomycin-C for their effects

ABSTRACT EFFECTS OF INFLIXIMAB, SIROLIMUS AND SUNITINIB ON WOUND HEALING IN EXPERIMENTAL GLAUCOMA FILTERING SURGERY AND COMPARISON WITH MITOMYCIN-C FOR THEIR EFFECTS It is well known that wound healing negatively affects the success of glaucoma filtering surgery. Currently antimetabolites and antifibrotic agents are being used to modulate wound healing. This experimental study is done to evaluate the effects of infliximab, sirolimus and sunitinib on wound healing in glaucoma surgery. In this study, forty two male New Zelland Albino rabbits were randomly subdivided into 6 equal groups. Limbal based trabeculectomy applied to five groups. Control group (Group I) was not performed surgery and not administered any drug postoperatively. %0, 9 NaCl four drops in a day was applied in Group II for 14 days after surgery, 0.4 mg/mL mitomycin-c (MMC) was intraoperatively applied scleral flap site for 3 minutes in Group III, infliximab 10 mg/mL 4x1 four drops in a day was applied in Group IV for 14 days after surgery, 30 ng/mL sirolimus soaked sponge was introperatively applied in Group V and sunitinib 0.5 mg/mL four drops in a day was applied in Group VI for 14 days after surgery. Operated eyes of rabbits was enucleated at the end of 14th day of the operation, on histopathological sections which were taken from bleb sites, fibroblasts and mononuclear cells (MNC) were stained with Masson-Trichrome and Hematoxylen-Eosin and evaluated histopathologically, additionally TGF-β , FGF-β and PDGF staining densities were evaluated immunohistochemically. In comparison with sham group, it was observed that fibroblast and MNC number were significantly supressed in MMC, infliximab, sirolimus and sunitinib groups. No difference has been found between the treatment groups (p>0.05) in terms of fibroblast and MNC number. In all treatment groups the immunohistochemical staining intensities of TGF- β , FGF- β and PDGF were suppressed (p<0.001). In comparison with the sham group no difference has been found between the treatment groups (p>0.05). As conclusion, when it was considered that antimetabolites have severe adverse effects, infliximab, sirolimus and sunitinib seems as safer methods in GFS. Key words: Trabeculectomy, wound healing, infliximab, sirolimus, sunitinib