ABSTRACT
The migration of cells is an intrinsic component of tissue contraction, which is important in filtration surgery failure. The matrix metalloproteinases (MMPs) are enzymes that degrade the extracellular matrix.The levels of MMPs in the vitreous relate to the development of retinal scarring.76 Their importance has been demonstrated by the fact that cell-mediated collagen contraction can be inhibited using MMP inhibitors. This applies to retinal pigment epithelium77 as well as Tenon’s fibroblasts.78 The authors have now shown a dramatic reduction in scarring in an experimental model with retention of normal tissue morphology using an MMP inhibitor (Figures 22.10 and 22.11) This action is equivalent to MMC without the deleterious side-effects.79 A number of agents can affect the cytoskeleton of the cell and hence inhibit migration, including taxol and etoposide (microtubule-stabilizing agents) and cytochalasin B (a microfilament inhibitor).Taxol and etoposide have been used in models of filtration surgery and prolong bleb survival,80
although neither have been assessed in human clinical trials to date.
