Effect of Lovastatin on Wound-Healing Modulation After Glaucoma Filtration Surgery in a Rabbit Model

Abstract

PURPOSE. To investigate the efficacy of lovastatin as an antifibrotic agent after glaucoma filtration surgery (GFS) in a rabbit model. METHODS. Thirty New Zealand white rabbits underwent GFS on the right eye. The rabbits were randomly assigned to one of three groups: (1) the mitomycin-C (MMC) group, which received 0.2 mg/mL MMC-soaked Weck-Cel under the conjunctival flap; (2) the control group, which received postoperative subconjunctival injections with 0.1 mL balanced salt solution (BSS); and (3) the lovastatin group, which received postoperative subconjunctival injection with 0.1 mL lovastatin (10 mu M). Intraocular pressure (IOP), bleb survival, and bleb morphology were examined until blebs showed evidence of failure. Three rabbits in each group were killed on postoperative day (POD) 5, and analyzed for histology and immunohistochemistry. RESULTS. Lovastatin significantly improved bleb survival compared with that in the control group (P = 0.002); however, no significant difference in bleb survival was observed between the MMC and lovastatin groups (P = 0.097). The lovastatin group showed significantly larger and higher blebs than did the control group. Further, the IOPs of the lovastatin and MMC groups were significantly lower than that of the control group (8.0 +/- 1.4 mm Hg, 7.9 +/- 3.2 mm Hg, and 11.1 +/- 2.9 mm Hg, respectively; P = 0.016) on POD 5. Histologic analyses revealed decreased inflammatory response and reduced fibrosis in the lovastatin group than in the control group. CONCLUSIONS. Postoperative injection of lovastatin improved bleb survival in the rabbit model of GFS. Therefore, lovastatin may have potential as a novel wound-modulating agent after GFS.