TREATMENT OF BLEB LEAKS WITH TRANSFORMING GROWTH-FACTOR-BETA IN THE RABBIT MODEL

Propose. The mechanism through which peribleb injection of autologous blood results in resolution of bleb leak in the rabbit model remains u nclear. This study evaluates the clinical and histologic effects of pe ribleb injection of transforming growth factor-beta (TGF-beta) after l eak induction in mitomycin-C-treated blebs. Method. Posterior lip scle rectomies treated with mitomycin-C were created in New Zealand White r abbits. On postoperative day 7, a standardized stab incision was perfo rmed on all blebs, and the eyes were randomized to receive a peribleb injection of either TGF-beta or of a balanced salt solution. Results. Injection of TGF-beta was associated with the resolution of bleb leak and maintenance of a functioning bleb in 50% (4 of 8) of treated eyes. The remaining TGF-beta-treated eyes and control eyes demonstrated con tinued bleb leaks or bleb failures with intraocular pressure returning to preoperative levels. Histologic examination revealed increased per ibleb cellularity and denser collagen deposition in the TGF-beta-treat ed eyes compared with that observed in control eyes. Conclusions. Peri bleb TGF-beta injections may contribute to healing bleb leaks, but the injections do not appear in this model to be as useful as whole-blood injections.