scholarly journals Bi-weekly Subconjunctival Injection of Bevacizumab for Corneal Neovascularization after Burn Injury

2021 ◽  
Vol 20 (4) ◽  
pp. 164-168
Author(s):  
In Hwan Hong ◽  
Jae Ryong Han ◽  
Min Ji Park
Keyword(s):  
Visual Acuity ◽  
Burn Injury ◽  
Corneal Edema ◽  
Corneal Neovascularization ◽  
Subconjunctival Injection ◽  
Bevacizumab Injection

Purpose: We report two cases of corneal neovascularization (NV) after burn injury successfully treated by subconjunctival bevacizumab injections at 2-week intervals.Case summary: Three bi-weekly subconjunctival injections of bevacizumab were administered to two patients with corneal NV after burn injury. In our first patient, corneal NV was markedly reduced by bevacizumab injection. The patient exhibited with a clear cornea and improved visual acuity (20/30) after treatment. Eleven weeks after the last injection, the cornea remained clear, with clinical regression of smaller vessels; the improvement in visual acuity was maintained. In the second case, the diameter of the vessels, hemorrhagic lesions, and corneal edema decreased/regressed, with improvement of the visual acuity to 20/25; these improvements persisted for 12 weeks after the last subconjunctival injection.Conclusions: Our results suggest that bi-weekly subconjunctival injection of bevacizumab is well-tolerated and effective for inhibiting chronic corneal NV after burn injury.

STUDY CLINICAL FEATURE AND RESULT OF TREATMENT PHACOMORPHIC GLAUCOMA

2015 ◽  
pp. 71-75
Author(s):  
Van Nam Phan ◽  
Ba Ken Tran
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Statistical Significance ◽  
Corneal Edema ◽  
Clinical Feature ◽  
Anterior Chamber Angle ◽  
Male Population ◽  
Significant Difference ◽  
Operative Complications ◽  
Before And After

Purpose: Study clinical feature of phacomorphic glaucoma. To evaluate the result of treatment phacomorphic glaucoma. Method: The retrospective, interventional study on 36 cases with phacomorphic glaucoma who underwent treated at Hue Central Hospital from 6/2010 to 6/2011. Standard of research: visual, IOP, before and after surgery, accompanying lesions and post-operative complications. The surgery is considered successful when postoperative IOP less than 21 mmHg. Results: Age 50-59 presented 30.5 percent, ≥ 60 presented 91.7 percent. There was a slight female preponderance (66.7%) compared to the male population (33.3%) which implies a statistically marginally significant difference. However there was no statistical significance difference when compared by the two subgroups. Patient in country presented 61,1% and city presented 38,9%. The duration between the onset of pain and surgery from 0 to < 5 days (77.8%), from 6 to 10 (16.7%) and >10 days presented 5.5%. The preoperative intraocular pressure 35 to 45mmHg (47.2%), 46-55 (30.6%), 56-65 (13.9%) and more than 65 presented 8.3%. The visual acuity preoperation less than 1metre count finger (94.5%), less than 3 metre count finger presented 5.5%. Close anterior chamber angle presented 80.6% and shallow was presented 19.4%. Corneal edema presented 100%, iritis presented 94.4%, dilated pupil larger 5mm presented 83.3%, Synchynea iris and cataract presented 72.2%. ECCE, implantation IOL combined trabeculectomy presented 11.1%, Phaco, implantation IOL combined trabeculectomy presented 69,5%, ECCE implantation IOL presented 5.6%, Phaco, implantation IOL presented 13.8%. Postoperative visual acuity from 1/10 to 5/10 presented 72.2%, no case have VA larger than 5/10. Postoperative 3 months VA 1/10 to 5/10 presented 72.2%, larger VA 5/10 presented 8.3%. Postoperative 3 months intraocular pressure ≤ 21mmHg presented 91.7%, 22 to 24mmHg presented 8.3%, no case have IOP ≥25mmHg. Postoperative edema presented 58.3%, iritis presented 58.3%. Key words: phacomorphic Glaucoma

scholarly journals Ion-Complex Microcrystal Formulation Provides Sustained Delivery of a Multimodal Kinase Inhibitor from the Subconjunctival Space for Protection of Retinal Ganglion Cells

Pharmaceutics ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 647
Author(s):  
Henry T. Hsueh ◽  
Yoo-Chun Kim ◽  
Ian Pitha ◽  
Matthew D. Shin ◽  
Cynthia A. Berlinicke ◽  
...  
Keyword(s):  
Retinal Ganglion Cells ◽  
Rat Model ◽  
Kinase Inhibitor ◽  
Ganglion Cells ◽  
Corneal Neovascularization ◽  
Therapeutic Effects ◽  
Subconjunctival Injection ◽  
Retinal Ganglion ◽  
Drug Concentrations ◽  
Complementary Strategy

Glaucoma is the leading cause of irreversible blindness worldwide. Elevated intraocular pressure (IOP) is one of the major risk factors for glaucoma onset and progression, and available pharmaceutical interventions are exclusively targeted at IOP lowering. However, degeneration of retinal ganglion cells (RGCs) may continue to progress despite extensive lowering of IOP. A complementary strategy to IOP reduction is the use of neuroprotective agents that interrupt the process of cell death by mechanisms independent of IOP. Here, we describe an ion complexation approach for formulating microcrystals containing ~50% loading of a protein kinase inhibitor, sunitinib, to enhance survival of RGCs with subconjunctival injection. A single subconjunctival injection of sunitinib-pamoate complex (SPC) microcrystals provided 20 weeks of sustained retina drug levels, leading to neuroprotection in a rat model of optic nerve injury. Furthermore, subconjunctival injection of SPC microcrystals also led to therapeutic effects in a rat model of corneal neovascularization. Importantly, therapeutically relevant retina drug concentrations were achieved with subconjunctival injection of SPC microcrystals in pigs. For a chronic disease such as glaucoma, a formulation that provides sustained therapeutic effects to complement IOP lowering therapies could provide improved disease management and promote patient quality of life.

scholarly journals Therapeutic effect of subconjunctival injection of bevacizumab in the treatment of corneal neovascularization

2009 ◽  
Vol 87 (6) ◽  
pp. 653-658 ◽  
Author(s):  
In-Cheon You ◽  
In-Seong Kang ◽  
Seung-Hyun Lee ◽  
Kyung-Chul Yoon
Keyword(s):  
Therapeutic Effect ◽  
Corneal Neovascularization ◽  
Subconjunctival Injection

Safety and Efficacy of Temporal Manual Small Incision Cataract Surgery in India

2011 ◽  
Vol 21 (6) ◽  
pp. 748-753 ◽  
Author(s):  
Swati V. Zawar ◽  
Parikshit Gogate
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Corneal Edema ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Safety And Efficacy ◽  
Excellent Outcome ◽  
Sutureless Technique ◽  
Small Incision ◽  
Sandwich Method

Purpose. To assess safety and efficacy of temporal manual small incision cataract surgery (SICS) in context to visual outcome, astigmatism, and complications. Methods. This involved sclerocorneal tunnel, capsulotomy and hydrodissection. The incision was made with number 11 disposable surgical blade (costing Indian Rs. 2.50, $0.05). Nucleus extraction was done by phaco-sandwich method with the help of vectis and dialer. Posterior chamber intraocular lens implantation was done according to biometric findings. A record of intraoperative and postoperative complications was made. The final postoperative assessment of astigmatism was done with spectacle correction on the 45th day as per the refraction findings. Results. Two thousand eyes were operated by temporal, manual small incision sutureless technique. Uncorrected visual acuity was ≥6/18 in 1636 (81.7%) patients on the first postoperative day, in 1652 (82.6%) patients at 2 weeks, and in 1732 (88.6%) patients at 6 weeks. Best-corrected visual acuity (BCVA) ≥6/18 was achieved in 1868 (93.4%) patients at 6 weeks, with 46 (2.3%) having BCVA <6/60, 24 (1.2%) of whom had preexisting retinal pathology. At 6 weeks, 1876 (93.8%) eyes had with-the-rule and 134 (6.2%) against-the-rule astigmatism (mean 0.7±1.25 D). Iris prolapse was noted in 3 (0.15%), wound leak in 3 (0.15%), and transient corneal edema in 136 (6.8%) eyes. Average surgery time was 6 minutes. Conclusions. Temporal SICS with number 11 disposable surgical blade and nucleus delivery by phaco-sandwich method gave excellent outcome with minimal astigmatism and low complication rate at economic cost.

Primary surgical options for acute corneal hydrops: A review

2021 ◽  
pp. 112067212110378
Author(s):  
Gonzalo García de Oteyza ◽  
Guido Bregliano ◽  
Irene Sassot ◽  
Luis Quintana ◽  
Carolina Rius ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Medical Therapy ◽  
Penetrating Keratoplasty ◽  
Corneal Transplantation ◽  
Corneal Edema ◽  
Self Healing ◽  
Surgical Options ◽  
Corneal Hydrops

Acute corneal hydrops usually resolves alone or with medical therapy along the first 4–6 weeks. However, depending on the severity of the corneal edema or the size of the Descemet break, self-healing might be difficult. Years ago, those patients had no more options than corneal transplantation, but surgical alternatives are on the rise in this century. These surgeries are becoming more popular with a variety of techniques relegating penetrating keratoplasty to a residual role. These techniques aim to accelerate corneal healing, reduce the edema, improve visual acuity and prevent from severe complications that may appear if corneal hydrops is not treated rapidly. Feasibility and safety are the favorable aspects of these techniques since the complications rates described remain low. In this review, we emphasize the recently published studies that describe both the techniques and their results.

scholarly journals Corneal Neovascularization and Lipid Keratopathy after Intacs SK in Keratoconus

2013 ◽  
Vol 2 (3) ◽  
pp. 133-138
Author(s):  
Ramez Barbara ◽  
David Zadok ◽  
Adel Barbara ◽  
Shay Gutfreund
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Corneal Neovascularization ◽  
Young Female ◽  
Spherical Equivalent ◽  
Corrected Visual Acuity ◽  
Optical Zone ◽  
Positive Results ◽  
Oval Shape ◽  
Best Corrected Visual Acuity

ABSTRACT Intacs have yielded positive results for the treatment of keratoconus in terms of reducing the keratometry readings astigmatism and spherical equivalent and consequently improving the uncorrected and best corrected visual acuity. Intacs severe keratoconus (SK) are new design of Intacs with a smaller optical zone (6 mm) and oval shape, they are indicated for severe keratocnus. Pannus is one of the complications of Intacs, as it has never been reported after Intacs SK. We report on corneal neovascularization in the corneal periphery which developed few months after Intacs SK implantation in the cornea of a young female who suffered from advanced keratoconus. The uncorrected visual (UCVA) acuity was satisfactory and the Intacs SK where not removed. Four years after the implantation she presented to our clinic complaining about eye irritation and photophobia, lipid keratopathy was observed. We gave here the choice of explanting the Intacs SK or to try to treat the neovascularization by subconjunctival Avastin, she preferred the second option because of a satisfactory UCVA (0.9). Avastin was injected in the subconjunctival, 10 weeks later Avastin and Kenelog were injected in the subconjunctival, few days after the second injection perforation and melting developed in the cornea, the patient underwent a tectonic graft and few months later penetrating keratoplasty with no intraoperative or postoperative complications. How to cite this article Barbara A, Zadok D, Gutfreund S, Barbara R. Corneal Neovascularization and Lipid Keratopathy after Intacs SK in Keratoconus. J Kerat Ect Cor Dis 2013;2(3):133-138.

scholarly journals SUBCONJUNCTIVAL INJECTION

2017 ◽  
Vol 24 (02) ◽  
pp. 296-301
Author(s):  
Faheem Ahmad ◽  
Tayyab Mushtaq
Keyword(s):  
Corneal Transplantation ◽  
Disease Process ◽  
Corneal Neovascularization ◽  
Age Related Macular Degeneration ◽  
University Hospital ◽  
Subconjunctival Injection ◽  
Rejection Reaction ◽  
Human Eye ◽  
Anti Vegf ◽  
Age Related

Introduction: Normally the cornea in human eye is crystalline clear membranepresent in the anterior most portion of the eyeball. Regarding the various functions of thecornea in human eye it provides protection, clear vision, refractive media the visual systemand maintains itself as an immune privileged site. Neovascularization is mostly associated withan inflammation and always indicate a state of disease. Similarly Corneal Neovascularizationcan cause Graft rejection reaction after keratoplasty the different types of anti-VEGF agentsnow are used to prevent neovascular eye diseases. These different Anti-VEGF inhibitors areLucentis, Macugen and bevacizumab/Avastin and used in case of ocular neovascularization.Objectives: To determine the efficacy of subconjuctival injection of Avastin on patients havingcorneal neovascularization following keratoplasty. Settings: Department of OphthalmologyAllied Hospital, Faisalabad and Independent University Hospital, Faisalabad. Study Duration:The duration of study was 11-02-2015 to 11-07-2015. Results: A total of 86 cases fulfilling theinclusion/exclusion criteria were enrolled to determine the efficacy of subconjuctival injectionof Avastin on patients having corneal neovascularization following keratoplasty. Discussion:Regarding the success of Keratoplasty is determined by many factors especially avascularity ofcornea after surgery. Corneal neovasculrization is disease process secondary to various ocularinsults in which growth of vessels towards central cornea occur from the limbal vascular plexus.But now a days Bevacizumab/Avastin is commonly used in Ophthalmology as “off label” drug inthe treatment of Exudative age related macular degeneration as well as in diabetic retinopathy.Conclusion: We concluded that the frequency of efficacy of subconjuctival bevacizumab ishigher in patients having corneal neovascularization after corneal transplantation.

scholarly journals Therapeutic HL-Contact Lens versus Standard Bandage Contact Lens for Corneal Edema: A Prospective, Multicenter, Randomized, Crossover Study

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Ofer Daphna ◽  
Michael Mimouni ◽  
Yariv Keshet ◽  
Meydan Ben Ishai ◽  
Irina S. Barequet ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Sodium Chloride ◽  
Crossover Study ◽  
Contact Lens ◽  
Day Treatment ◽  
Corneal Edema ◽  
Treatment Allocation ◽  
Improvement Rate ◽  
Bandage Contact Lens ◽  
Randomized Crossover Study

Introduction. To compare the safety and efficacy of the Therapeutic Hyper-CL™ lens versus a standard bandage contact lens (PureVision B&L) for chronic corneal edema. Methods. Prospective, multicenter, randomized, crossover study. Chronic corneal edema patients were randomized to one of two arms. The first arm was fitted with the Therapeutic Hyper-CL™ lens while the second arm was fitted with a standard soft bandage contact lens. Both arms were treated with 5% sodium chloride 6 times a day. After a 7-day treatment period, there was a 7-day washout period, after which the arms were crossed over. Patients were evaluated at days 0 (baseline), 7 (following first treatment allocation), 14 (following washout), and 21 (following second treatment allocation). The primary outcomes were 3 lines of BCVA (best corrected visual acuity) improvement. Results. In total, 49 patients were enrolled. There was significantly greater BCVA improvement rate >3 lines (30.4% versus 17.4%, P=0.04) in the Therapeutic Hyper-CL™ lens group. The mean change in BCVA lines was significantly greater for the Therapeutic Hyper-CL™ lens (3.4 ± 6.7 versus 0.9 ± 2.3, P=0.02). Conclusions. The Therapeutic Hyper-CL™ lens was associated with a higher chance for significant visual acuity improvement when compared to a standard bandage contact lens combined with 5% sodium chloride. This trial is registered with NCT02660151.

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