Purpose:

Subconjonctival fibrosis has an important role on results of glaucoma surgery. We investigated histologically the effect of infliximab ( a TNF alpha inhibitor) on conjunctiva and tenon fibroblastic activity of rabbit eyes during wound healing period of the surgical wound.

Material and Methods:

The surgical wound model was created with a standart protocol ( fornix- based conjunctival fleb and scleral fleb with 2/3 of scleral thickness) on twenty-one eyes of 11 albino rabbits. Infliximab was used different doses (2 mg/ml or 5 mg/ml), different times (3 seconds or 5 seconds) or alternative application routes ( topical or subconjunctival(SC)) on eighteen eyes (groups A-B-C-D-E-F). Three eyes had only surgical approach without drug application (control eyes, group G). The pathological slices were taken on the surgical area and the examples were painted with Bromodeoxyuridine (BrdU). Fibroblasts counts and the ratio of fibroblasts counts/ cell counts (proliferative index) were measured with light microscopy. Statistical analysis was made with Mann Whitney U test. Statistically significance was accepted p<0,05.

Results:

In groups B,C,D and F (with high dose topical/SC infliximab); fibroblasts counts and proliferative index was lower than controls (group G)(p<0,05). Low dose topical infliximab (group A) and SC infliximab group (group E) was no affect shown on the fibroblastic activity (p>0,05).

Conclusion:

Dose and time dependent topical infliximab application has an inhibitory effect of tenon and conjunctival fibroblastic activity during wound healing of rabbit eyes. We though that this effect may prevent subconjunctival fibrosis has a negative effect on results of glaucoma surgery.

Keywords: TNF alpha inhibitors, fibroblast, wound healing, glaucoma surgery