Turkiye Klinikleri Journal of Case Reports

TAVŞANLARDA DENEYSEL FİLTRAN GLOKOM CERRAHİSİNDE İNTRAOPERATİF' LOKAL MİTOMİSİN VE 5- FLOROURASİL UYGULAMASININ GÖZİÇİ BASINCI VE YARA İYİLEŞME SÜRECİNE ETKİSİ
Effects of Intraoperative Local Mitomycin and 5-Fluorouracil Application on Intraocular Pressure and Wound Healing Process in the Experimental Glaucoma Filtering Surgery in Rabbits
Ahmet ÖZER*, Nilgün YILDIRIM*, Nevin KURTDERE**, Murat ERÇAKIR***, Firdevs GÜRER***, Reşat Nuri AŞTI**, Sumru YURDAKUL*, Attila TANYOLAÇ**, Hikmet BAŞMAK*

*Department of Ophthalmology, Medical School of Osmangazi University, Eskişehir,
**Department of Histology-Embryology, Veterinary Faculty of Ankara University, Ankara,
***Department of Histology-Embryology, Medical School of Osmangazi University, Eskişehir, TURKEY
Turkiye Klinikleri J Med Res. 2001;19(2):69-78
Article Language: TR
Full Text
ÖZET
Amaç: Bu çalışmada tavşanlarda deneysel fıltran glokom cerrahisinde intraoperatif lokal mitomisin ve 5-florourasil (5-FU) uygulamasının göziçi basıncı ve yara iyileşme sürecine etkisi incelendi Metod: 21 tavşanın 42 gözü örnek olarak alınarak fıltran glokom cerrahisinde intraoperatif lokal mitomisin ve 5-FU uygulamasının göziçi basıncı ve yara iyileşme sürecine etkileri araştırıldı. Sağ gözlerin 11ine mitomisin, 10una 5-FU uygulandı. Bütün sol gözler kontrol grubu olarak değerlendirildi. Operasyondan sonraki 32. günde mitomisin ve 5-FU grubundan 3er tavşanın, 60. günde ise diğer tüm tavşanların gözleri histopatolojik çalışma için enüklee edildi. Histolojik değerlendirme elektron mikroskopik ağırlıklı olarak yapıldı. Sonuçlar: Göziçi basıncı fıltran glokom cerrahisi uygulanan bütün gruplarda anlamlı düzeyde düşük olarak bulundu (p<0.001). Mitomisin ve 5-FU grubunda göziçi başmandaki düşüklük kontrol grubuna gore daha belirgindi (p<0.01). Göziçi basıncı mitomisin grubunda ilk 5 gün daha düşükken, 5. günden sonraki günlerde mitomisin ve 5-FU grubu arasında bir fark yoktu (p>0.05). Blep oluşumu mitomisin ve 5-FU grubunda kontrol grubundan daha fazlaydı (p<0.01). Gruplar arasında ön kamera derinliği, kornea epitel defekti ve diğer komplikasyonlar yönünden bir fark yoktu (p>0.05). Işık ve elektron mikroskopla yapılan histopatolojik muayenede mitomisin ve 5-FU grubunda yara iyileşme sürecinde gecikme olduğu ve bu etkinin mitomisin grubunda daha belirgin olduğu görüldü. Yorum: İntraoperatif lokal mitomisin ve 5-FU uygulaması göziçibasıncını düşürmekte ve yara iyileşme sürecini geciktirmektedir.

Anahtar Kelimeler: Filtran glokom cerrahisi, Mitomisin, 5-florourasil, Yara iyileşmesi
ABSTRACT
Purpose: The purpose of this study is to investigate the effects of intraoperative local mitomycin and 5-fluorouracil (5-FU) application on intraocular pressure and the wound healing process in the experimental glaucoma filtering surgery in rabbits. Methods: Taking 42 eyes of 21 rabbits as a sample the effects of intraoperative local mitomycin and 5-FU application on the intraocular pressure and wound healing process in glaucoma filtering surgery were studied. Mitomycin was applied on 11 and 5-FU on the remaining 10 right eyes. All 21 left eyes served as controls. On the 32nd day after the operation, the eyes of three rabbits from both mitomycin and 5-FU groups; and on the 60th day, all remaining eyes were enucleated for histopathological examination. Ultrastructure evaluation was based on transmission electron microscopy. Results: Intraocular pressure was found to be significantly lower in all glaucoma filtering surgery groups (p<0.001). Mitomycin and 5-FU application further lowered the intraocular pressure as compared to control group (p<0.01). While intraocular pressures were lower in the first 5 days in the mitomycin group, the difference between mitomycin and 5-FU groups was not significant after 5 days (p>0.05). Bleb formation was significantly higher in the mitomycin and 5- FU groups than the control group (p<0.01). There was no difference among groups with respect to their anterior chamber depth, corneal epithelial defects and other complications (p>0.05). Histopathologic examination by light and electron microscopy revealed that mitomycin and 5-FU application delayed the wound healing process; and this effect was found to be more marked with the use of mitomycin. Conclusions: Intraoperative local mitomycin and 5-FU application further lowered the intraocular pressure and delayed the wound healing process.

Keywords: Glaucoma filtering surgery, Mitomycin, 5-fluorouracil, Wound healing

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