The inflammatory and foreign body reaction of polymethyl methacrylate glaucoma drainage device in the rabbit eye

Virna D. Oktariana Asrory, Ratna Sitompul, Widya Artini, Sri Estuningsih, Deni Noviana, William H. Morgan

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Purpose: To assess the safety and tissue response of a polymethyl methacrylate (PMMA) glaucoma drainage device (GDD) in the rabbit eye. Methods: Specially constructed PMMA GDD devices were implanted into rabbit eyes and evaluated histopathologically following euthanasia on days 5, 30, and 60 after implantation surgery. Hematoxylin-eosin, Masson’s trichrome, and periodic acid-Schiff were used to stain tissue specimens dissected from the surgical site. Inflammatory cell count and capsule thickness measurements were performed. Results: Three rabbits were sacrificed on day 5, 3 on day 30, and 4 on day 60. Macrophage and lymphocyte counts increased from day 5 to day 30 then decreased (P = 0.0000) with greater counts seen in the superior regions. At day 30, a fibrous capsule had formed around the plate area. Fibroblast counts increased significantly between day 5 to day 30 and again to day 60 (P = 0.001) with greatest numbers anteriorly. The inferior capsule thickness at day 60 was 243 μm (standard deviation, 120; 95% confidence interval: 53-433). The superior capsule thickness was 388 μm (standard deviation, 136; 95% confidence interval: 172-604). No adverse reactions were seen. Conclusions: Histopathologically, the inflammatory response toward this PMMA glaucoma drainage device was comparable to other reported GDDs. No accentuated response or adverse event was seen suggesting that PMMA may be useful as a GDD material. Translational Relevance: An affordable, locally built GDD is needed in Indonesia because of the high prevalence of severe glaucoma. This rabbit study is a significant step toward justifying the use of PMMA as a GDD material. PMMA is cheap and easily manufactured and sterilized in developing economies.

Original languageEnglish
Article number20
JournalTranslational Vision Science and Technology
Issue number3
Publication statusPublished - 1 Jan 2020


  • Foreign body reaction
  • Glaucoma drainage device
  • Inflammatory reaction
  • Polymethyl methacrylate


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