Effects of bevacizumab loaded PEG-PCL-PEG hydrogel intracameral application on intraocular pressure after glaucoma filtration surgery

2015 ◽  
Vol 26 (8) ◽  
Author(s):  
Qian Han ◽  
Yuqi Wang ◽  
Xiabin Li ◽  
Ribo Peng ◽  
Ailing Li ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery

scholarly journals Avoiding BAK in postoperative eye drops reduces the need for subconjunctival 5-FU injections post-trabeculectomy

2020 ◽  
Vol 17 (1) ◽  
pp. 128-131
Author(s):  
Keith Ong ◽  
Leonard Ong
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
T Test ◽  
Topical Steroids ◽  
Eye Drops ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery ◽  
Group A ◽  
Group B ◽  
Causes Of Failure

Purpose: Subconjunctival fibrosis is one of the main causes of failure of glaucoma filtration surgery. It can result in absence of a filtration bleb, a small scarred bleb, or a cystic bleb. 5-Fluorouracil (5-FU), mitomycin C (MMC), and topical steroids have been used to suppress subconjunctival fibrosis. Method: A study was done analyzing the number of postoperative subconjunctival 5-FU injections for trabeculectomy on pseudophakic eyes prior to and following the change to a BAK-free regimen. The cohort consisted of 16 consecutive cases undergoing primary trabeculectomy without intraoperative MMC or 5-FU. The trabeculectomy surgery included a groove sclerectomy procedure. Group A were 8 eyes of patients who had the author’s standard Chlorsig, Maxidex, and Prednefrin Forte eye drops tds. Group B were 8 eyes who had Chlorsig-dexamethasone and Optive-dexamethasone tds eye drops postoperatively. Results: Group B (BAK-free) patients required fewer postoperative 5-FU subconjunctival injections (average: 2.9, range: 1-5 injections) compared to Group A (BAK) patients (average: 7.3, range: 4-18 injections). This difference was statistically significant (P = 0.02, unpaired t-test). All patients had functioning blebs and did not require glaucoma medications to maintain target intraocular pressure. The Group B (BAK-free) patients had more diffuse blebs than the Group A (BAK) patients. Conclusion: The results demonstrated that when BAK was eliminated from postoperative eye drops in trabeculectomy, the number of postoperative 5-FU injections was reduced.

Bleb reconstruction using donor scleral patch graft for late bleb leak and hypotony

2020 ◽  
pp. 112067212092434
Author(s):  
Michael O’Rourke ◽  
Sarah Moran ◽  
Niamh Collins ◽  
Aoife Doyle
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Standard Deviation ◽  
Late Complication ◽  
Case Series ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery ◽  
Operative Care ◽  
Patch Graft ◽  
Bleb Leak

Purpose Bleb dysfunction may occur as a late complication following glaucoma filtration surgery. Over-filtering, thinning and cystic blebs can lead to hypotony, leak and corneal dellen. We report our surgical management and outcomes of this specific entity using donor scleral patch grafts. Methods This is a 10-year non-comparative, retrospective interventional case series. Bleb reconstruction involved excision of encysted conjunctiva and sclera to identify the original fistula. A functioning donor scleral patch graft was sited over this with fixed and releasable sutures and the conjunctiva advanced. Intraocular pressure, visual acuity and post-operative issues were assessed. Results A total of 18 eyes of 17 patients with mean age 65 years (standard deviation 13.5) were included. Trabeculectomy was the primary procedure in 72% ( n = 13) and deep sclerectomy in 28% ( n = 5). Bleb leak accounted for 61% ( n = 11), hypotony 33% ( n = 6) and corneal dellen 6% ( n = 1). Mean pre-operative intraocular pressure was 7 mm Hg (standard deviation 4.6) which increased to 18.5 mm Hg (standard deviation 12) at day 1 ( p < 0.001), 11.8 mm Hg (standard deviation 4.6) at 3 months ( p < 0.05), 12.1 mm Hg (standard deviation 4.2) at 1 year ( p < 0.01) which was maintained at 12.1 mm Hg (standard deviation 5.3) at last follow-up ( p < 0.001). Post-operative interventions included bleb needling, re-suturing, suture removal, further glaucoma management, bleb leak and cataract surgery. Visual acuity also improved post-operatively and was maintained. Conclusion Reconstruction of the filtering bleb architecture with donor sclera results in improved intraocular pressure while maintaining visual acuity. Post-operative care is required to support the restored bleb function. Our findings support the use of scleral patch graft as an effective and safe method for the long-term management of hypotony and bleb leak as a late complication of glaucoma filtration surgery.

scholarly journals AR12286 Alleviates TGF-β-Related Myofibroblast Transdifferentiation and Reduces Fibrosis after Glaucoma Filtration Surgery

Molecules ◽  
2020 ◽  
Vol 25 (19) ◽  
pp. 4422
Author(s):  
Wen-Sheng Cheng ◽  
Ching-Long Chen ◽  
Jiann-Torng Chen ◽  
Le-Tien Lin ◽  
Shu-I Pao ◽  
...  
Keyword(s):  
Cell Migration ◽  
Intraocular Pressure ◽  
Kinase Inhibitor ◽  
Control Group ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery ◽  
Collagen Contraction ◽  
Β Receptor ◽  
Tgf Β1

Scar formation can cause the failure of glaucoma filtration surgery. We investigated the effect of AR12286, a selective Rho-associated kinase inhibitor, on myofibroblast transdifferentiation and intraocular pressure assessment in rabbit glaucoma filtration surgery models. Cell migration and collagen contraction were used to demonstrate the functionality of AR12286-modulated human conjunctival fibroblasts (HConFs). Polymerase chain reaction quantitative analysis was used to determine the effect of AR12286 on the production of collagen Type 1A1 and fibronectin 1. Cell migration and collagen contraction in HConFs were activated by TGF-β1. However, compared with the control group, rabbit models treated with AR12286 exhibited higher reduction in intraocular pressure after filtration surgery, and decreased collagen levels at the wound site in vivo. Therefore, increased α-SMA expression in HConFs induced by TGF-β1 could be inhibited by AR12286, and the production of Type 1A1 collagen and fibronectin 1 in TGF-β1-treated HConFs was inhibited by AR12286. Overall, the stimulation of HConFs by TGF-β1 was alleviated by AR12286, and this effect was mediated by the downregulation of TGF-β receptor-related SMAD signaling pathways. In vivo results indicated that AR12286 thus improves the outcome of filtration surgery as a result of its antifibrotic action in the bleb tissue because AR12286 inhibited the TGF-β receptor-related signaling pathway, suppressing several downstream reactions in myofibroblast transdifferentiation.

Microspheres scar formation glaucoma filtration surgery area therapeutic effect—Based on rapamycin-chitosan-calcium alginate sustained-release

2020 ◽  
Vol 10 (6) ◽  
pp. 848-855
Author(s):  
Shasha Wang ◽  
Feiping Xu ◽  
Jie He ◽  
Tingyi Cao ◽  
Rui Liu ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Sustained Release ◽  
Release Rate ◽  
Calcium Alginate ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery ◽  
Group A ◽  
Group B ◽  
The Right ◽  
Sustained Release Microspheres

To study the efficacy of rapamycin (RAPA)-chitosan (CS)-calcium alginate (CA) sustained-release microspheres on scar formation in a rabbit model of glaucoma filtration surgery. Eighty New Zealand white rabbits were randomly divided into four groups and a glaucoma filtration model was established by scleral bite through the eyes. RAPA-CS-CA sustained-release microspheres were implanted in the right eye of 40 rabbits (Group A) and CS blank sustained-release microspheres were implanted in the left eye (Group B). Another 40 rabbits were treated with a 0.2 g·L-1 RAPA cotton sheet in the right eye (Group C) and the left eye underwent a simple sclerotomy (Group D). The intraocular pressure, filter bleb, anterior chamber inflammation, complications, and corneal endothelial cell density were observed after the operation. Rabbits were euthanized for pathological examination 7 days, 14 days, and 21 days after the operation. The drug loading rate of RAPA-CS-CA sustainedrelease microspheres was (34.58±1.47)% and the encapsulation rate was (56.23±1.55)%. The microsphere release in vitro was relatively stable. The release rate of the microspheres during the burst was only 16.54%. After 49 days, the cumulative release rate of the microspheres reached 94.07% and the sustained release effect was significant within 45 days. Group A maintained low-level intraocular pressure for the longest period of time, followed by Group C, and then Group B and D. The survival time of filter vesicles in Group A was longer than that in other groups. There were no postoperative complications in each group. The conjunctival epithelium of Group A had better integrity and fewer subconjunctival fibroblasts than other groups. There was no obvious inflammation or infiltration around the filtering mouth and there were fewer new collagen fibers. RAPA-CS-CA slow-release microspheres safely and effectively inhibited the proliferation of fibroblasts and neonatal collagen fibers in rabbit glaucoma filtration surgery and significantly improved the success rate of glaucoma filtration surgery.

Bleb-less Surgery and Phaco – the iStent Saga

2014 ◽  
Vol 08 (02) ◽  
pp. 104
Author(s):  
J Garcia Feijoo ◽  
Keyword(s):  
Intraocular Pressure ◽  
Minimally Invasive ◽  
Gold Standard ◽  
Rapid Evolution ◽  
Glaucoma Surgery ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery ◽  
New Techniques ◽  
The Past ◽  
Corneal Incisions

In the past years there is been a rapid evolution of cataract surgery; however, in glaucoma filtration surgery is still the ‘gold standard’. New techniques and devices have been developed and may change the surgical algorithm. Minimally invasive glaucoma surgery (MIGS) is safe, can be performed abinternothrough sub-1.8 mm corneal incisions and a postop intraocular pressure in mid-teens can be obtained.

Comparison of phaco time parameters in eyes with and without glaucoma filtration surgery due to pseudoexfoliation glaucoma

2021 ◽  
pp. 112067212110177
Author(s):  
Ayse Gul Kocak Altintas ◽  
Cagri Ilhan
Keyword(s):  
Clinical Characteristics ◽  
Pseudoexfoliation Glaucoma ◽  
Filtration Surgery ◽  
Glaucoma Filtration Surgery ◽  
Mean Values ◽  
Time Parameters ◽  
The Mean ◽  
Group 2 ◽  
Surgical Manipulations ◽  
Phaco Time

Purpose: To compare the phaco time parameters including ultrasound time (UST), effective phaco time (EPT), and average phaco power (APP) in eyes with pseudoexfoliation glaucoma (PEG) and had or had not glaucoma filtration surgery. Methods: In this retrospective comparative study, Group 1 was constructed with 84 PEG patients who had not operated previously, and Group 2 was constructed with 49 PEG patients who had glaucoma filtration surgery. The mean values of UST, EPT, and APP were compared. The preoperative clinical characteristics and surgical manipulations were also compared. Results: The mean ages and male-to-female ratios of the groups were similar ( p > 0.05, for both). There was no difference in the preoperative clinical characteristics, including biometric values between the groups ( p > 0.05, for all). Some surgical manipulations, including pupillary stretching ( p = 0.004), pupillary membrane peeling ( p = 0.021), iris hook using ( p = 0.041), and capsular tension ring implantation ( p = 0.041), were significantly performed more commonly in Group 2. Although the mean UST and EPT values were similar ( p > 0.05, for both), the mean APP value was significantly lower in Group 2 ( p = 0.011). Conclusion: The lower APP parameter was observed in PEG patients having had glaucoma filtration surgery. Needing more surgical manipulation to overcome poor pupillary dilation and weak zonular instability can be a reason for this result.

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