Impact of non-aqueous fluid flow on protein profile in glaucoma drainage device implants

Glaucoma surgery, particularly trabeculectomy, has high failure rates. Failure is typically defined by postoperative intraocular pressure (IOP) exceeding the target IOP. Glaucoma drainage devices (GDDs) also have high failure rates, often leading to a thick fibrous capsule. A new model, the "CERA" implant, has been used to study bleb capsule porosity in rabbits, showing that NZW rabbits developed thick capsules with low porosity at 4 weeks. The study aims to understand the effect of non-aqueous fluid (BSS) flow on the proteome responsible for capsular porosity.

Methodology: Twenty-eight days after tube surgery, animals were anesthetized, and the implant's capsule porosity was tested by the flow of BSS into the capsule measured at 12 mm Hg for 5 minutes, followed by a 30-minute fluid challenge at the same pressure.

The study utilized Metaboanalyst to identify proteins and analyze their expression patterns at different times. A heat map was used to visualize the data.

Results: Many proteins showed upregulation at the 24 and 48-hour time points. These proteins were involved in oxygen transport, regulating calcium homeostasis, blood coagulation, and immune and defense responses.

Conclusion: The study revealed a time-dependent control of proteins associated with immunity and defense. The findings highlight the dynamic nature of the immune response and the complex interactions between proteins and immune response pathways. These proteins maintain immunological processes, and calcium homeostasis, and limit excessive bleeding and wound healing. The study also suggests that the immune system is important for tissue regeneration and repair.