Pharmacological Approaches to Modulate the Scarring Process after Glaucoma Surgery

Author:

Collotta Debora1ORCID,Colletta Simona1ORCID,Carlucci Virginia2ORCID,Fruttero Claudia3,Fea Antonio Maria4,Collino Massimo1ORCID

Affiliation:

1. Department of Neurosciences “Rita Levi Montalcini”, University of Turin, 10126 Turin, Italy

2. Chemsafe S.r.l., Via Ribes 5, 10010 Colleretto Giacosa, Italy

3. Hospital Pharmacy, S. Croce e Carle Hospital Cuneo, 12100 Cuneo, Italy

4. Struttura Complessa Oculistica, Città Della Salute e Della Scienza di Torino, Dipartimento di Scienze Chirurgiche, Università degli Studi di Torino, 10126 Torino, Italy

Abstract

Glaucoma is an acquired optic neuropathy that results in a characteristic optic nerve head appearance and visual field loss. Reducing the IOP is the only factor that can be modified, and the progression of the disease can be managed through medication, laser treatment, or surgery. Filtering procedures are used when target pressure cannot be obtained with less invasive methods. Nevertheless, these procedures require accurate control of the fibrotic process, which can hamper filtration, thus, negatively affecting the surgical success. This review explores the available and potential pharmacological treatments that modulate the scarring process after glaucoma surgery, analyzing the most critical evidence available in the literature. The modulation of scarring is based on non-steroidal anti-inflammatory drugs (NSAIDs), mitomycin, and 5-fluorouracil. In the long term, the failure rate of filtering surgery is mainly due to the limitations of the current strategies caused by the complexity of the fibrotic process and the pharmacological and toxicological aspects of the drugs that are currently in use. Considering these limitations, new potential treatments were investigated. This review suggests that a better approach to tackle the fibrotic process may be to hit multiple targets, thus increasing the inhibitory potential against excessive scarring following surgery.

Publisher

MDPI AG

Subject

Drug Discovery,Pharmaceutical Science,Molecular Medicine

Reference40 articles.

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5. Wallace, H.A., Basehore, B.M., and Zito, P.M. (2022). Wound Healing Phases, StatPearls.

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