Reduction of the scleral adhesion of tenon fibroblasts

• Applicants: Privatdozent Dr. Jan Lübke; Professor Dr. Jürgen Rühe
• Subject Area: Biomaterials ; Ophthalmology ; Polymer Materials
• Term: since 2013
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 235242641

Glaucoma is a chronic progressive disease of the optic nerve, a leading cause of irreversible blindness. The reduction of intraocular pressure (IOP) is currently the only evidence-based treatment. If this cannot be achieved sufficiently by medication, incisional surgery creates an outflow pathway for the aqueous to the subconjunctival space (glaucoma filtering surgery, i.e. trabeculectomy). The success of the treatment is strongly limited by the postoperative wound healing, an actually physiological process that, in this situation leads to scarring and failure of the artificial fistula. So far, postoperative wound healing in glaucoma filtration surgery is modified and suppressed by cytotoxic agents with, in turn, increased risk for sight-threatening complications. Attempts to selectively interfere with activated pro-inflammatory cytokines have been unsuccessful so far. The aim of this project proposal is to prevent the formation of adhesive scar tissue formed by tenon-fibroblasts occluding the created fistula. The lack of adhesion of scar tissue guarantees flow of aqueous liquid under the conjunctiva, irrespective of cytokine alterations. Long term success of fistulation (meaning low IOP) is thereby improved for the patient. Scleral coatings made of polymeric materials are to be developed for this purpose. These polymeric networks are fixed on the scleral tissue by covalent bonds under in-vivo compatible conditions. The aim is to locally prevent all types of cellular adhesion on the polymeric material. Physiologic, postoperative scarring will then not be able to occlude the surgical fistula by adhesion to the underlying tissue. In the first part of this project, methods and materials are developed in-vitro and biocompatibility is tested in an in-vivo animal model. The second part of the project will then aim to transfer the results to human application.

• DFG Programme: Research Grants
• Co-Investigator: Dr. Oswald Prucker