Glaucoma Wound Healing Research

Trabeculectomy complications can include excessive scarring, which may affect how successfully the surgery lowers eye pressure. This project studies the wound healing process following trabeculectomy, or glaucoma filtration surgery, which lowers intraocular pressure by creating a new drainage pathway for fluid inside the eye.

During surgery, surgeons make a small hole in the sclera and cover it with a thin “trap-door.” Aqueous humor then drains through this trap-door into a bleb just under the eye surface, hidden by the eyelid. However, excessive scarring can close this pathway, causing pressure to rise again. Importantly, some trabeculectomy complications such as these can impact both short- and long-term outcomes.

To study wound healing after this surgery, our lab uses primary human Tenon’s capsule and scleral fibroblast cells – the cells responsible for post-surgery scarring. We hypothesize that blocking the TGFβ2-TLR4 pathway will reduce scarring and maintain lower intraocular pressure, thereby minimizing complications of trabeculectomy.

Finally, we will test four inhibitors that target molecules in this pathway. Also, examining the effects on complications, including those specific to trabeculectomy, is part of our plan. We will examine their effects on cell viability, metabolism, proliferation, and migration, all crucial factors in fibrosis and wound healing.

Future Directions: The Data Generated From The Fibroblasts Cells Can Be Used To Further Test Whether Inhibition Of TGFβ2-TLR4 Signaling Molecules Can Prevent Scar Formation And Maintain The Reduced IOP After Glaucoma Filtration Surgery. Overall, understanding trabeculectomy complications is critical to enhancing patient outcomes.

-Dr. Colleen McDowell, NTERI