Use of growth factor and antimetabolite combination to prevent or retard

Abstract

The intraocular use of combinations of stromal cell growth stimulators (e.g., TGF-.beta.) and antimetabolites (e.g., mitomycin C) in connection with glaucoma filtration surgery is described. The combination is applied to the surgical site to attract, mitogenically activate, and neutralize the potential for extracellular matrix synthesis leading to scar formation by stromal cells. Without such treatment, the formation of scar tissue may lead to impairment of the outflow of aqueous humor at the surgical site, particularly the fistula. The mitogenic activation of the stromal cells makes these cells susceptible to the anti-metabolites. This enables the antimetabolites to suppress the proliferation of the fibroblasts and other associated stromal cells to a much greater extent, relative to the proliferation seen when the metabolites alone are utilized. The increased suppression of the proliferation and metabolism of these cells results in a significant improvement in the ability to prevent or retard the formation of scar tissue, and thereby reduces the incidence of fistula closure following glaucoma filtration surgery.