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Agnifili L, Figus M, Sacchi M, Oddone F, Villani E, Ferrari G, Posarelli C, Carnevale C, Nucci P, Nubile M, Mastropasqua L. Managing the ocular surface after glaucoma filtration surgery: an orphan topic. Graefes Arch Clin Exp Ophthalmol 2024; 262:2039-2056. [PMID: 38091058 DOI: 10.1007/s00417-023-06333-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/06/2023] [Accepted: 12/05/2023] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Ocular surface (OS) disorders before glaucoma filtration surgery (GFS) have been considered to play a crucial role influencing the surgical outcome. Conversely, the impact of surgery itself on the OS is almost completely overlooked, though evidence suggest that ocular surface disease (OSD) may be induced in patients by GFS. This review analyzes the determinants involved in the OSD development after GFS, the clinical features and related consequences, the main diagnostic hallmarks, as well as the therapeutic strategies for its management. METHODS The PubMed database was utilized for the literature examination. Keywords that were searched included ocular surface disease, glaucoma filtration surgery, filtration bleb, post-surgical management, and quality of life. RESULTS After GFS, OSD is promoted by peri- and post-operative factors, such as the filtration bleb (FB) development, combined surgical approach with phacoemulsification, the use of antifibrotic agents and the reintroduction of antiglaucoma medications. This particular form of OSD that present similar clinical features to mild to moderate dry eye, can be named as post-glaucoma surgery-OSD (PGS-OSD). PGS-OSD may negatively affect the FB functionality, thus potentially hindering the disease control, and significantly worsen the patient quality of life (QOL). CONCLUSIONS Clinicians are encouraged to routinely include the OS evaluation after GFS and to consider proper management when the occurrence of PGS-OSD worsen the patient's QOL or exert negative effects to the FB functionality. An outline summarizing the main risk factors and the most appropriate therapeutic options to mitigate the PGS-OSD was proposed to support the routine practice.
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Affiliation(s)
- Luca Agnifili
- Ophthalmology Clinic, Department of Medicine and Aging Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy.
| | - Michele Figus
- Ophthalmology Unit, Department of Surgery, Medicine, Molecular and Emergency, University of Pisa, Pisa, Italy
| | - Matteo Sacchi
- University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | | | - Edoardo Villani
- University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Giulio Ferrari
- IRCCS San Raffaele Scientific Institute, Division of Neuroscience, Cornea and Ocular Surface Disease Unit, Eye Repair Lab, Milan, Italy
- Vita-Salute San Raffaele University, Department of Ophthalmology, Milan, Italy
| | - Chiara Posarelli
- Ophthalmology Unit, Department of Surgery, Medicine, Molecular and Emergency, University of Pisa, Pisa, Italy
| | | | - Paolo Nucci
- University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Mario Nubile
- Ophthalmology Clinic, Department of Medicine and Aging Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Aging Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
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Golmohammadi M, Meibodi SAA, Al-Hawary SIS, Gupta J, Sapaev IB, Najm MAA, Alwave M, Nazifi M, Rahmani M, Zamanian MY, Moriasi G. Neuroprotective effects of resveratrol on retinal ganglion cells in glaucoma in rodents: A narrative review. Animal Model Exp Med 2024; 7:195-207. [PMID: 38808561 PMCID: PMC11228121 DOI: 10.1002/ame2.12438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/22/2024] [Indexed: 05/30/2024] Open
Abstract
Glaucoma, an irreversible optic neuropathy, primarily affects retinal ganglion cells (RGC) and causes vision loss and blindness. The damage to RGCs in glaucoma occurs by various mechanisms, including elevated intraocular pressure, oxidative stress, inflammation, and other neurodegenerative processes. As the disease progresses, the loss of RGCs leads to vision loss. Therefore, protecting RGCs from damage and promoting their survival are important goals in managing glaucoma. In this regard, resveratrol (RES), a polyphenolic phytoalexin, exerts antioxidant effects and slows down the evolution and progression of glaucoma. The present review shows that RES plays a protective role in RGCs in cases of ischemic injury and hypoxia as well as in ErbB2 protein expression in the retina. Additionally, RES plays protective roles in RGCs by promoting cell growth, reducing apoptosis, and decreasing oxidative stress in H2O2-exposed RGCs. RES was also found to inhibit oxidative stress damage in RGCs and suppress the activation of mitogen-activated protein kinase signaling pathways. RES could alleviate retinal function impairment by suppressing the hypoxia-inducible factor-1 alpha/vascular endothelial growth factor and p38/p53 axes while stimulating the PI3K/Akt pathway. Therefore, RES might exert potential therapeutic effects for managing glaucoma by protecting RGCs from damage and promoting their survival.
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Affiliation(s)
- Maryam Golmohammadi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Jitendra Gupta
- Institute of Pharmaceutical Research, GLA University, Mathura, India
| | - Ibrohim B Sapaev
- Tashkent Institute of Irrigation and Agricultural Mechanization Engineers, Tashkent, Uzbekistan
- New Uzbekistan University, Tashkent, Uzbekistan
| | - Mazin A A Najm
- Pharmaceutical Chemistry Department, College of Pharmacy, Al-Ayen University, Thi-Qar, Iraq
| | - Marim Alwave
- Medical Technical College, Al-Farahidi University, Baghdad, Iraq
| | - Mozhgan Nazifi
- Department of Neurology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammadreza Rahmani
- Physiology-Pharmacology Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Physiology and Pharmacology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mohammad Yasin Zamanian
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Gervason Moriasi
- Department of Medical Biochemistry, School of Medicine, College of Health Sciences, Mount Kenya University, Thika, Kenya
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Ahmadzadeh A, Kessel L, Schmidt BS, Kolko M, Bach-Holm D. Steroids and/or Non-Steroidal Anti-Inflammatory Drugs as Postoperative Treatment after Trabeculectomy-12-Month Results of a Randomized Controlled Trial. J Clin Med 2024; 13:887. [PMID: 38337581 PMCID: PMC10856597 DOI: 10.3390/jcm13030887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
This prospective randomized controlled trial aimed to compare the efficacy and safety of topical preservative-free diclofenac (DICLO) to dexamethasone (DEX) eyedrops, and their combination (DEX+DICLO) after trabeculectomy. Sixty-nine patients with medically uncontrolled glaucoma were randomized to receive topical postoperative treatment with DICLO (n = 23), DEX (n = 23), or a combination of DEX and DICLO (n = 23). The primary outcome was the intraocular pressure (IOP) 12 months postoperatively. Secondary outcomes included surgical success, failure, visual field, and visual acuity from baseline to 12 months postoperatively. IOP reached the lowest point one day after trabeculectomy. At 12 months, IOP was 10.0 mmHg (95% CI, 8.4-11.6 mmHg) for DICLO, 10.9 mmHg (95% CI, 9.4-12.3 mmHg) for DEX, and 11.2 mmHg (95% CI, 9.1-13.3 mmHg) for DEX+DICLO. There were no significant differences in IOP, surgical success, failure, visual field, or visual acuity between the DICLO, DEX, or DEX+DICLO groups. We found that topical diclofenac was not statistically different from topical dexamethasone in controlling IOP 12 months after trabeculectomy. Combining diclofenac and dexamethasone offered no added IOP control compared to dexamethasone alone.
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Affiliation(s)
- Afrouz Ahmadzadeh
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
| | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
| | | | - Miriam Kolko
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Drug Design and Pharmacology, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Daniella Bach-Holm
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
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Ahmadzadeh A, Schmidt BS, Bach-Holm D, Kessel L. Early Inflammation Control After Trabeculectomy by Steroid and Non-steroidal Eye Drops: A Randomized Controlled Trial. Ophthalmol Ther 2023; 12:969-984. [PMID: 36602718 PMCID: PMC10011236 DOI: 10.1007/s40123-022-00636-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/06/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION To compare the effect of three different anti-inflammatory regimens consisting of preservative-free dexamethasone (DEX), diclofenac (DICLO) eye drops, and their combination (DEX + DICLO) following trabeculectomy on early postoperative inflammation. METHODS A prospective randomized controlled trial. Sixty-nine patients undergoing trabeculectomy were randomized to receive either postoperative treatment with topical DEX (n = 23), topical DICLO (n = 23), or a combination of topical DEX and topical DICLO (n = 23) after trabeculectomy. The primary outcome was the anterior chamber flare measurement in the first 3 months postoperatively. Secondary outcomes included intraocular pressure, central corneal thickness, conjunctival injection, and number of cells in the anterior chamber from baseline to 3 months postoperatively. RESULTS Anterior chamber flare reached a maximum 1 day after trabeculectomy with an increase of 55% (95% CI 37-73%) for DEX, 64% (95% CI 47-82%) for DICLO, and 57% (95% CI 39-75%) for DEX + DICLO and returned to near pre-operative values 6 weeks after surgery. There were no significant differences in anterior chamber flare [effect size for DICLO: 0.16 (95% CI - 4.3 to 4.6), effect size for DEX + DICLO: 0.09 (95% CI - 4.1 to 4.3)], intraocular pressure, central corneal thickness, conjunctival injection, or number of cells in the anterior chamber between DEX, DICLO, or DEX + DICLO groups. CONCLUSION We found that topical diclofenac was not statistically different from topical dexamethasone in controlling early postoperative inflammation after trabeculectomy, while combining diclofenac and dexamethasone offered no added anti-inflammatory control compared to dexamethasone alone. TRIAL REGISTRATION www. CLINICALTRIALS gov (NCT04054830).
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Affiliation(s)
- Afrouz Ahmadzadeh
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet-Glostrup, Valdemar Hansens Vej 1-23, 2600, Glostrup, Denmark.
| | | | - Daniella Bach-Holm
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet-Glostrup, Valdemar Hansens Vej 1-23, 2600, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet-Glostrup, Valdemar Hansens Vej 1-23, 2600, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Sim JJL, Man REK, Foo RCM, Huang OS, Betzler BK, Husain R, Ho CL, Boey PY, Perera SA, Low JR, Aung T, Lamoureux EL, Wong TT. Oral Ibuprofen is Associated With Reduced Likelihood of Early Bleb Failure After Trabeculectomy in High-Risk Glaucoma Patients. J Glaucoma 2023; 32:237-244. [PMID: 36930580 DOI: 10.1097/ijg.0000000000002188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/14/2023] [Indexed: 03/18/2023]
Abstract
PRCIS Individuals prescribed ibuprofen after trabeculectomy have better postoperative intraocular pressure (IOP) control and a higher chance of bleb survival despite being at a higher risk of scarring. PURPOSE To investigate the effects of early adjunctive oral ibuprofen treatment on IOP and bleb failure in eyes at high risk of scarring. METHODS In these retrospective analyses, 288 eyes of 273 patients (mean ± SD age: 68.56 ± 10.47 y; 32.60% females) with primary glaucoma who underwent trabeculectomy/phacotrabeculectomy at the Singapore National Eye Centre between April 2020 and April 2021 with a follow-up duration ≥1 year were included. Of these, 77 (26.7%) eyes deemed to be at high risk of scarring were administered oral ibuprofen ≥3 months postoperatively (mean ± SD ibuprofen administration duration: 4.08 ± 2.28 wk). Participant's IOPs at baseline and at postoperative weeks 1, 2-3; and months 1, 2, 3, 6, and 12 were recorded. Bleb failure was defined as 2 consecutive IOP readings of >21, >18, and >15 mm Hg, and/or requiring remedial postoperative laser or surgery. RESULTS The ibuprofen group experienced significantly greater postoperative IOP reductions at week 1 [mean difference, 95%CI: -2.89 (-5.22, -0.56) mm Hg] and month 1 [-2.29 (-4.53, -0.05) mm Hg]; and substantially lower odds of bleb failure at the >18 mm Hg [odds ratio, 95% CI: 0.39 (0.20-0.79)] and >15 mm Hg [0.52 (0.29-0.94)] thresholds, compared with the non-ibuprofen group. No differences in adverse ocular hypotony events were observed. CONCLUSION Early adjunctive oral ibuprofen administered to individuals at high risk of posttrabeculectomy scarring is associated with greater IOP reductions and reduced likelihood of bleb failure. Our results suggest that oral nonsteroidal anti-inflammatory drugs may be a safe way of improving trabeculectomy survival in high-risk eyes.
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Affiliation(s)
| | - Ryan Eyn Kidd Man
- Duke-NUS Medical School, National University of Singapore
- Singapore National Eye Centre
- Singapore Eye Research Institute, Singapore
| | | | - Olivia S Huang
- Duke-NUS Medical School, National University of Singapore
- Singapore National Eye Centre
| | | | - Rahat Husain
- Duke-NUS Medical School, National University of Singapore
- Singapore National Eye Centre
| | - Ching Lin Ho
- Duke-NUS Medical School, National University of Singapore
- Singapore National Eye Centre
| | - Pui Yi Boey
- Duke-NUS Medical School, National University of Singapore
- Singapore National Eye Centre
| | - Shamira A Perera
- Duke-NUS Medical School, National University of Singapore
- Singapore National Eye Centre
- Singapore Eye Research Institute, Singapore
| | - Jin Rong Low
- Singapore National Eye Centre
- Singapore Eye Research Institute, Singapore
| | - Tin Aung
- Yong Loo Lin School of Medicine
- Duke-NUS Medical School, National University of Singapore
- Singapore National Eye Centre
- Singapore Eye Research Institute, Singapore
| | - Ecosse L Lamoureux
- Duke-NUS Medical School, National University of Singapore
- Singapore National Eye Centre
- Singapore Eye Research Institute, Singapore
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital
- Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
| | - Tina T Wong
- Yong Loo Lin School of Medicine
- Duke-NUS Medical School, National University of Singapore
- Singapore National Eye Centre
- Singapore Eye Research Institute, Singapore
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Iris abnormalities may influence the efficacy and filtration strategies of Posner-Schlossman syndrome: a retrospective study involving trabeculectomy, ExPRESS and Ahmed valve implants. Graefes Arch Clin Exp Ophthalmol 2023; 261:791-801. [PMID: 36303060 DOI: 10.1007/s00417-022-05865-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/26/2022] [Accepted: 10/07/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To evaluate and compare the one-year efficacy and influencing factors of different filtration surgeries on Posner-Schlossman syndrome (PSS) patients. METHODS A retrospective study enrolling 91 PSS patients who underwent filtering surgeries and were followed for at least one year. Unilateral PSS was diagnosed as recurrent attacks of mild, unilateral, non-granulomatous anterior uveitis, elevated intraocular pressure (IOP), keratic precipitates (KPs) on the corneal endothelium, open angle, no posterior synechia, and no inflammatory lesions in the posterior segment; the IOP and anterior segment returned to normal between attacks. Medical histories and thorough ocular examination results were collected. Trabeculectomy and ExPRESS were chosen as the first line and AGV was considered for those under high risk of fibrosis. Follow-up data, mainly IOP, best-corrected visual acuity (BCVA), and anterior segment manifestations at the 1st week, 6th month, and 12th month were generated and analyzed. Iris abnormalities were determined by depigmentation or atrophic changes on the anterior segment photograph. Complete surgical success was defined as 5 mmHg < IOP ≤ 21 mmHg without IOP-lowering drug or needle revision; qualified surgical success was defined as 5 mmHg < IOP ≤ 21 mmHg with IOP-lowering drugs or needle revisions. Survival analysis was performed to obtain the success rates. RESULTS At the 12th month, the complete surgical success rate of trabeculectomy (N = 54), ExPRESS (N = 23), and AGV group (N = 14) was 58.97% (95%CI 46.91-77.09%), 84.21% (95%CI 68.33-100.87%), and 100%; the qualified success rate was 71.79% (95%CI 62.46-88.34%), 89.47% (95%CI 77.07-103.33%), and 100%, respectively. Patients undergoing trabeculectomy experienced the largest decline of BCVA (from 0.58±0.46 to 1.01±0.51, P < .05); the trabeculectomy group endured the highest IOP (20.84±9.92 mmHg) compared to ExPRESS (14.51±2.86 mmHg, P < .05) and AGV group (13.17±3.32 mmHg, P < .05). At the 12th month, in the ExPRESS group, patients with iris abnormalities had higher IOP than the normal ones (15.65±2.05 mmHg, 12.93±3.17 mmHg, P < .05). ExPRESS helped patients with iris abnormalities maintain lower IOP than trabeculectomy (15.65±2.05 mmHg, 22.52±10.67 mmHg, P < .05). Three patients developed hypotony at the 3rd month (1 in ExPRESS and 2 in trabeculectomy group). CONCLUSION AGV and ExPRESS performed better than trabeculectomy in PSS patients in terms of IOP and success rate. Iris abnormalities might influence the postoperative IOP and this may be valuable in guiding filtration strategies. TRIAL REGISTRATION Chinese Clinical Trial Registry (No. ChiCTR1800017532, date: 2018/08/02).
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Ahmadzadeh A, Kessel L, Schmidt BS, Bach-Holm D. Steroid Response after Trabeculectomy-A Randomized Controlled Trial Comparing Dexamethasone to Diclofenac Eye Drops. J Clin Med 2022; 11:jcm11247365. [PMID: 36555981 PMCID: PMC9784245 DOI: 10.3390/jcm11247365] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/03/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
This prospective randomized controlled trial aimed to compare changes in intraocular pressure in three different anti-inflammatory regimens following trabeculectomy. Sixty-nine patients were randomized to receive either postoperative prophylaxis with topical preservative-free dexamethasone (DEX), diclofenac (DICLO), or their combination (DEX+DICLO). Our main outcome measure was an intraocular pressure (IOP) change of a minimum 4 mmHg following the withdrawal of anti-inflammatory prophylaxis 9 weeks after trabeculectomy. We found that the IOP decreased ≥ 4 mmHg in 18.6% of eyes after cessation of the topical steroid DEX (n = 3/22) and DEX+DICLO (n = 5/21), whereas a decrease in IOP was not observed in the DICLO group. In conclusion, IOP decreased in nearly 1/5 of patients after cessation of topical steroidal anti-inflammatory prophylaxis after trabeculectomy. This points toward a steroid-induced increase in IOP even after trabeculectomy. Thus, increased postoperative IOP may be related to steroid use, and the success or failure of a trabeculectomy cannot be fully evaluated before anti-inflammatory prophylaxis with steroids is stopped or changed to non-steroidal eye drops.
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Affiliation(s)
- Afrouz Ahmadzadeh
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet, 2600 Copenhagen, Denmark
- Correspondence:
| | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet, 2600 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark
| | | | - Daniella Bach-Holm
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet, 2600 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark
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Vinokurtseva A, Armstrong JJ, Liu H, Hutnik CML. Differential effects of acetylsalicylic acid and mitomycin C on cytokine-induced Tenon's capsule myofibroblast transdifferentiation and activity: Implications for glaucoma surgery. Exp Eye Res 2022; 225:109284. [PMID: 36273575 DOI: 10.1016/j.exer.2022.109284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/08/2022] [Accepted: 10/13/2022] [Indexed: 12/29/2022]
Abstract
Inflammation-driven scarring is a major contributor to surgical failure after subconjunctival bleb forming glaucoma surgery. The current gold standard anti-scarring adjuvant mitomycin C (MMC) has variable effectiveness and is associated with significant risks. Acetylsalicylic acid (ASA), when delivered locally, repurposes the typically pro-inflammatory cyclooxygenase (COX-2) signaling for the resolution of inflammation and mitigating inflammation-mediated fibrosis. The aim of this study is to compare the effects of ASA and MMC in an in vitro model of subconjunctival scarring. Glaucoma patient-derived Tenon's capsule fibroblasts (HTCFs) were treated with TGFβ1 (2 ng/mL) plus or minus ASA (1600 μg/ml), or MMC (0.05, 0.1, 0.2 mg/mL). In vitro collagen contraction, MTT, LDH, immunofluorescence, and Western blot assays were performed. To elucidate the mechanistic effects of ASA in TGFβ1-induced HTCFs, liquid chromatography tandem mass spectrometry (LC-MS/MS) was used to identify and measure pro-inflammatory and pro-resolving lipid mediator secretion. ASA was at least as effective as MMC in reducing TGFβ1-induced HTCF-mediated collagen contraction, metabolic activity, and pro-fibrotic protein expression, with less cytotoxicity. Within cytokine-activated HTCFs, ASA significantly impaired secretion of pro-inflammatory lipid mediators prostaglandin E2 and 6-keto-prostaglandin F1α and significantly increased secretion of the pro-resolving mediators 5-hydroxyeicosatetraenoic acid (HETE), 15-HETE and 18-hydroxyeicosapentaenoic acid (HEPE). ASA reduces cytokine-induced myofibroblast transdifferentiation in HTCFs, being non-inferior to MMC in vitro. ASA's effects are associated with a unique lipid mediator expression profile, suggesting that the ASA-induced resolution of inflammation may be a promising strategy to mitigate inflammation-mediated scarring and could offer a novel alternative as a surgical adjuvant.
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Affiliation(s)
- Anastasiya Vinokurtseva
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
| | - James J Armstrong
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; Ivey Eye Institute, St. Joseph's Health Care, London, ON, Canada
| | - Hong Liu
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; Department of Pathology and Laboratory Medicine, Western University, London, ON, Canada
| | - Cindy M L Hutnik
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; Ivey Eye Institute, St. Joseph's Health Care, London, ON, Canada; Department of Pathology and Laboratory Medicine, Western University, London, ON, Canada
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Massote JA, Oliveira VDMM, Cronemberger S. Glaucoma drainage devices. REVISTA BRASILEIRA DE OFTALMOLOGIA 2022. [DOI: 10.37039/1982.8551.20220041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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10
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Wang L, Li H, Zhang W, Ren M, Shao M, Wang J. AGTR1 blocker attenuates activation of Tenon's capsule fibroblasts after glaucoma filtration surgery via the NF-κB signaling pathway. Exp Cell Res 2021; 407:112786. [PMID: 34411608 DOI: 10.1016/j.yexcr.2021.112786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/12/2021] [Accepted: 08/15/2021] [Indexed: 11/21/2022]
Abstract
Activation of Tenon's capsule fibroblasts limits the success rate of glaucoma filtration surgery (GFS), the most efficacious therapy for patients with glaucoma. Angiotensin type 1 receptor (AGTR1) is involved in tissues remodeling and fibrogenesis. However, whether AGTR1 is involved in the progress of fibrogenesis after GFS is not fully elucidated. The aim of this study was to investigate the role of an AGTR1 in scar formation after GFS and the potential anti-fibrosis effect of AGTR1 blocker. AGTR1 expression level was increased in subconjunctival tissues in a rat model of GFS and transforming growth factor-beta 2 (TGF-β2)-induced human Tenon's capsule fibroblasts (HTFs). AGTR1 blocker treatment suppressed TGF-β2-induced HTF migration and α-smooth muscle actin (α-SMA) and fibronectin (FN) expression. AGTR1 blocker treatment also attenuated collagen deposition and α-SMA and FN expression in subconjunctival tissues of the rat model after GFS. Moreover, AGTR1 blocker decreased TGF-β2-induced P65 phosphorylation, P65 nuclear translocation, and nuclear factor kappa B (NF-κB) luciferase activity. Additionally, BAY 11-7082 (an NF-κB inhibitor) significantly suppressed HTF fibrosis. In conclusion, our results indicate that AGTR1 is involved in scar formation after GFS. The AGTR1 blocker attenuates subconjunctival fibrosis after GFS by inhibiting the NF-κB signaling pathway. These findings indicate that targeting AGTR1 is a potential approach to attenuate fibrosis after GFS.
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Affiliation(s)
- Lijun Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Hongsong Li
- Department of Ophthalmology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Wenyi Zhang
- Department of Ophthalmology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Meimei Ren
- Department of Ophthalmology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Meilin Shao
- Department of Ophthalmology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Jianming Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China.
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11
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A Tenon's capsule/bulbar conjunctiva interface biomimetic to model fibrosis and local drug delivery. PLoS One 2020; 15:e0241569. [PMID: 33141875 PMCID: PMC7608904 DOI: 10.1371/journal.pone.0241569] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/18/2020] [Indexed: 12/13/2022] Open
Abstract
Glaucoma filtration surgery is one of the most effective methods for lowering intraocular pressure in glaucoma. The surgery efficiently reduces intra-ocular pressure but the most common cause of failure is scarring at the incision site. This occurs in the conjunctiva/Tenon’s capsule layer overlying the scleral coat of the eye. Currently used antimetabolite treatments to prevent post-surgical scarring are non-selective and are associated with potentially blinding side effects. Developing new treatments to target scarring requires both a better understanding of wound healing and scarring in the conjunctiva, and new means of delivering anti-scarring drugs locally and sustainably. By combining plastic compression of collagen gels with a soft collagen-based layer, we have developed a physiologically relevant model of the sub-epithelial bulbar conjunctiva/Tenon’s capsule interface, which allows a more holistic approach to the understanding of subconjunctival tissue behaviour and local drug delivery. The biomimetic tissue hosts both primary human conjunctival fibroblasts and an immune component in the form of macrophages, morphologically and structurally mimicking the mechanical proprieties and contraction kinetics of ex vivo porcine conjunctiva. We show that our model is suitable for the screening of drugs targeting scarring and/or inflammation, and amenable to the study of local drug delivery devices that can be inserted in between the two layers of the biomimetic. We propose that this multicellular-bilayer engineered tissue will be useful to study complex biological aspects of scarring and fibrosis, including the role of inflammation, with potentially significant implications for the management of scarring following glaucoma filtration surgery and other anterior ocular segment scarring conditions. Crucially, it uniquely allows the evaluation of new means of local drug delivery within a physiologically relevant tissue mimetic, mimicking intraoperative drug delivery in vivo.
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Clinical practice preferences for glaucoma surgery in Japan: a survey of Japan Glaucoma Society specialists. Jpn J Ophthalmol 2020; 64:385-391. [PMID: 32474840 DOI: 10.1007/s10384-020-00749-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/02/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE This study evaluated the surgical practice patterns of glaucoma management followed by glaucoma specialists in Japan. METHODS A survey was administered to 50 glaucoma specialists who were councilors in the Japan Glaucoma Society about surgical preferences and postoperative glaucoma care. RESULTS All 50 glaucoma specialists participated in the survey. Results show that, in 2019, compared to conventional trabeculotomy (4.6%), the frequency of minimally invasive glaucoma surgery (MIGS), combined with phacoemulsification, remarkably increased (79.0%) for non-operated eyes with mild open-angle glaucoma associated with cataract. Tube-shunt surgery was performed more often for open-angle glaucoma with previously twice failed trabeculectomy (65.8%) and neovascular glaucoma with previously once failed trabeculectomy (63.4%). In addition, during one year post-operatively, MIGS required less frequent follow-up visits compared to filtering surgery. CONCLUSION Although glaucoma specialists in the Japan Glaucoma Society usually prefer trabeculectomy, in the past decade they have selected tube-shunt surgery more often to treat refractory glaucoma. MIGS is increasing remarkably as the choice primary glaucoma surgery.
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Ioannidis AS, Töteberg-Harms M, Hamann T, Hodge C. Refractive Outcomes After Trabecular Micro-Bypass Stents (iStent Inject) with Cataract Extraction in Open-Angle Glaucoma. Clin Ophthalmol 2020; 14:517-524. [PMID: 32158184 PMCID: PMC7044743 DOI: 10.2147/opth.s239103] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/30/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Simultaneous cataract and glaucoma surgery has traditionally been challenging for the anterior segment surgeon. The introduction of minimally invasive glaucoma surgery (MIGS) in conjunction with cataract surgery appears safe and effective in lowering intraocular pressure. Although a significant visual impact leading from the combined procedure is unexpected, we aim to describe the refractive outcomes in a cohort of patients undergoing simultaneous cataract removal and iStent inject and discuss the potential implications of combined surgery in patients with co-existent glaucoma. Patients and Methods This is a retrospective consecutive case series inclusive of patients undergoing combined femtosecond laser-assisted cataract surgery and the insertion of two trabecular micro-bypass stents (iStent inject). Visual acuity, refraction and astigmatic vector analysis were collated and analysed from the preoperative and 4 weeks postoperative visits. Results One hundred and six eyes of 89 patients from 2 surgeons were included in the original cohort. The mean absolute difference from target refraction was 0.36 ± 0.25D. 73.9% of eyes were within ± 0.5D of the refractive target and 98.9% of eyes were within ± 1.00D. 73.8% of eyes had 0.5D or less residual refractive astigmatism following the procedure. Conclusion We present a novel cohort of glaucoma patients undergoing combined trabecular micro-bypass stents (iStent inject) and cataract surgery achieving excellent refractive outcomes. The results of this study indicate that this second-generation device is refractively neutral.
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Affiliation(s)
- Alexandros S Ioannidis
- Vision Eye Institute Blackburn South, Melbourne, VIC, Australia.,Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Marc Töteberg-Harms
- Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland
| | - Timothy Hamann
- Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland
| | - Christopher Hodge
- Vision Eye Institute Blackburn South, Melbourne, VIC, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
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Comparison of ExPress Implantation and Partial Deep Sclerectomy Combined with ExPress Implantation and Simultaneous Phacoemulsification. J Ophthalmol 2019; 2019:7424376. [PMID: 31885894 PMCID: PMC6915013 DOI: 10.1155/2019/7424376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 03/31/2019] [Accepted: 04/28/2019] [Indexed: 11/17/2022] Open
Abstract
Background To compare the effectiveness and safety profile of ExPress implantation versus partial deep sclerectomy combined with ExPress implantation and simultaneous phacoemulsification. Patients and Methods A prospective, randomized control study with 24-month follow-up was performed. 114 eyes were included, of which 42 eyes underwent phacoemulsification with simultaneous implantation of the Ex-Press device (ExPress), and deep sclerectomy with phacoemulsification and simultaneous implantation of the Ex-Press device (DS-ExPress) was performed in 72 eyes. The main outcome measures were intraocular pressure (IOP), corrected distance visual acuity (CDVA), the number of antiglaucoma medications, and the rate of complications. Surgical success was defined as complete (without antiglaucoma medications) with IOP ≤18 mmHg in criterion A, IOP ≤16 mmHg in criterion B, and IOP ≤12 mmHg in criterion C. Satisfactory success was defined as the same IOP levels for individual criteria with a maximum of 2 antiglaucoma medications. Results Before the procedure, mean IOP in the ExPress group was 17.5 ± 4.7 mmHg; after 24 months, it decreased by 13% to 16.0 ± 3.0 mmHg (P < 0.05). In the DS-ExPress group, mean IOP reduced from 16.3 ± 4.4 mmHg to 14.3 ± 3.3 mmHg (P < 0.05), which was a 9% reduction compared to the initial value. In the DS-ExPress group, 65.9% of the patients did not use topical pharmacotherapy, and the same is true for 29.2% of the ExPress group (P=0.004). Conclusions This modification is efficient in surgical treatment of glaucoma, especially when very low postoperative IOP is needed. A less amount of antiglaucoma medicines are needed.
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Armstrong JJ, Denstedt JT, Trelford CB, Li EA, Hutnik CML. Differential effects of dexamethasone and indomethacin on Tenon's capsule fibroblasts: Implications for glaucoma surgery. Exp Eye Res 2019; 182:65-73. [PMID: 30910611 DOI: 10.1016/j.exer.2019.03.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/28/2019] [Accepted: 03/19/2019] [Indexed: 12/16/2022]
Abstract
Dysregulated wound healing and subsequent fibrosis represents the most common cause of failure in glaucoma filtration surgery. Primary means to prevent this outcome are the anti-metabolite surgical adjuvants, however, topical corticosteroids are commonly used postoperatively to permit further control of wound healing and development of the filtration bleb. Unfortunately, they carry important side effects such as raised intraocular pressure, cataract and increased infection risk. Non-steroidal anti-inflammatory drugs (NSAIDs) show promising results in clinical trials as an alternative wound modulatory drug. NSAIDs exhibit non-inferiority to steroids in terms of post-operative intraocular pressure control and secondary IOP lowering interventions, however there is little known about the differing effects these drugs exert on human Tenon's capsule fibroblast (HTCF) mediated wound healing. The purpose of this study was to assess the individual effects of dexamethasone and indomethacin on the extracellular matrix modifying actions of HTCFs in vitro. To this end, HTCFs were cultured in 3D collagen matrices as well as in 2D monolayers and exposed to clinically relevant concentrations of dexamethasone or indomethacin for up to seven days. HTCF-mediated wound healing functions were assayed through collagen matrix contraction, extracellular matrix morphology, estimation of HCTF proliferation and differentiation into myofibroblasts within the collagen matrices, as well as western blot. Both drugs significantly reduced HTCF-mediated collagen contraction relative to control however there was a significant trend towards greater inhibition with indomethacin exposure compared to dexamethasone. Indomethacin exposure significantly reduced HTCF-mediated collagen remodelling activity compared vehicle control, whereas dexamethasone was unable to reduce remodelling activity at any of the studied exposures. Both drugs reduced myofibroblast differentiation, however indomethacin alone demonstrated an inhibitory effect on final cell number relative to control whereas dexamethasone had no significant effect at any studied exposure. These findings demonstrate that both steroidal and NSAID treatment can mitigate HTCF-mediated collagen contraction and αSMA expression. However, NSAIDs may function to better impede HTCF proliferation and remodelling activity. Taken in the context of previous glaucoma surgical trials, NSAIDs appear to be a viable alternative to steroids for post-operative wound modulation.
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Affiliation(s)
- James J Armstrong
- Schulich School of Medicine and Dentistry Department of Ophthalmology, London, Ontario, Canada; Schulich School of Medicine and Dentistry Department of Pathology and Laboratory Medicine, London, Ontario, Canada; Ivey Eye Institute, St. Joseph's Healthcare, London, Ontario, Canada.
| | - James T Denstedt
- Ivey Eye Institute, St. Joseph's Healthcare, London, Ontario, Canada
| | - Charles B Trelford
- Schulich School of Medicine and Dentistry Department of Pathology and Laboratory Medicine, London, Ontario, Canada
| | - Erica A Li
- Schulich School of Medicine and Dentistry Department of Pathology and Laboratory Medicine, London, Ontario, Canada
| | - Cindy M L Hutnik
- Schulich School of Medicine and Dentistry Department of Ophthalmology, London, Ontario, Canada; Schulich School of Medicine and Dentistry Department of Pathology and Laboratory Medicine, London, Ontario, Canada; Ivey Eye Institute, St. Joseph's Healthcare, London, Ontario, Canada
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Almatlouh A, Bach‐Holm D, Kessel L. Steroids and nonsteroidal anti-inflammatory drugs in the postoperative regime after trabeculectomy - which provides the better outcome? A systematic review and meta-analysis. Acta Ophthalmol 2019; 97:146-157. [PMID: 30242968 DOI: 10.1111/aos.13919] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 08/16/2018] [Indexed: 12/14/2022]
Abstract
Surgical outcome after trabeculectomy depends on maintaining a functional bleb which requires a delicate balance between incomplete wound healing to prevent fibrosis and enough wound healing to prevent hyperfiltration. Thus, controlling the inflammatory response is essential. We conducted a systematic review and meta-analysis to compare the effectiveness of different formulations of steroids (topical, systemic and depot) and nonsteroidal anti-inflammatory drugs (NSAIDs) in achieving long-term pressure control with fewer antiglaucomatous medications, preserving visual acuity and visual fields while considering surgical and postoperative complications. We used the PubMed, EMBASE and Cochrane Libraries to identify randomized controlled trials (RCTs) comparing the effect of different formulations of steroids (topical, systemic or depot) to NSAIDs. Data on prespecified outcomes from eligible references were entered into a meta-analysis using the Review Manager 5.3 program. We identified seven RCTs with a total of 342 included patients. Topical steroids were superior to placebo in controlling intraocular pressure (IOP) and reducing the risk of complications. Supplementing topical steroids with a perioperative steroid depot (subtenon or intracamerally) or systemic steroids in the early postoperative period did not provide better outcome or a change in the risk of complications. Addition of topical NSAIDs to topical steroids in patients undergoing trabeculectomy did not change the outcome or risk profile. For patients undergoing phacotrabeculectomy and topical NSAID, there was a nonsignificant trend towards better intermediate IOP control and a reduced need for antiglaucomatous medications compared to topical steroids but there was no difference in effect for patients undergoing trabeculectomy. In conclusion, there is a low level of evidence to support the clinician in deciding which postoperative regime provides a more favourable outcome because of inconsistency in the reported outcomes between studies and a low number of patients for each comparable intervention and outcome. It does seem that topical steroids are better than no anti-inflammatory treatment after glaucoma surgery, but further research is recommended.
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Affiliation(s)
- Amir Almatlouh
- Department of Ophthalmology Rigshospitalet‐Glostrup Copenhagen Denmark
| | - Daniella Bach‐Holm
- Department of Ophthalmology Rigshospitalet‐Glostrup Copenhagen Denmark
- Faculty of Health Sciences Institute of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Line Kessel
- Department of Ophthalmology Rigshospitalet‐Glostrup Copenhagen Denmark
- Faculty of Health Sciences Institute of Clinical Medicine University of Copenhagen Copenhagen Denmark
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Jacobovitz S, Massote JA, Cronemberger S. Laminar drainage implant. Eur J Ophthalmol 2018; 29:278-286. [PMID: 30474392 DOI: 10.1177/1120672118815066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the feasibility of a novel surgical technique in painful blind eyes. DESIGN A prospective safety study conducted at the Federal University of Minas Gerais, Brazil. PARTICIPANTS/SAMPLES A total of 15 end-stage glaucomatous eyes without light perception vision. METHODS After implantation, conjunctival hyperemia, discharge, erosion, aqueous humor leakage, corneal edema, hyphema, anterior chamber cells and depth, dislocation of the implant, and filtering bleb height were assessed by slit-lamp biomicroscopy. Intraocular pressure was measured preoperatively and 24 months following surgery. A numerical rating scale was used to evaluate pain. Anterior segment optical coherence tomography was also assessed. RESULTS Laminar drainage implant surgery was performed in all patients without major complications. Mean intraocular pressure was significantly reduced after surgery without hypotensive medication (preoperatively 54.5 ± 5.1 mmHg vs 24 months after surgery 37.0 ± 15.4 mmHg, p = 0.003). Subjective ocular pain intensity also reduced (preoperatively 10 vs at 24-month follow-up visits 0). Corneal edema incidence reduced from 85.7% (95% confidence interval: 57.2%-98.2%) to 16.7% (95% confidence interval: 2.1%-48.4%) at the 24-month follow-up. No patients experienced a prolonged flat anterior chamber or erosion of overlying tissues. CONCLUSION The surgery was feasible and safe in painful blind eyes.
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Affiliation(s)
- Sergio Jacobovitz
- Hospital Sao Geraldo, HC-Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - José Aloísio Massote
- Hospital Sao Geraldo, HC-Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Di Y, Luo XM, Qiao T, Lu N. Intraocular pressure with rebound tonometry and effects of topical intraocular pressure reducing medications in guinea pigs. Int J Ophthalmol 2017; 10:186-190. [PMID: 28251075 DOI: 10.18240/ijo.2017.02.02] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 07/26/2016] [Indexed: 12/25/2022] Open
Abstract
AIM To investigate the intraocular pressure (IOP) of adult guinea pig eyes with rebound tonometry (RBT), and assess the effects of four distinctive topical IOP reducing medications including Carteolol, Brimonidine, Brinzolamide and Latanoprost. METHODS The IOPs of twenty-four 12-week-old guinea pigs (48 eyes) were measured every two hours in one day with RBT as baselines. All the animals were then divided into four groups (Carteolol, Brimonidine, Brinzolamide and Latanaprost groups, n=6). The IOPs were measured and compared to the baseline 1, 2, 3, 5, 7, 9, 15 and 24h after treatment. RESULTS The mean baseline IOP of 24 guinea pigs (48 eyes) was 10.3±0.36 mm Hg (6-13 mm Hg) and no binocular significant differences of IOPs were observed (t=1.76, P>0.05). No significant difference of IOP in Carteolol group at each time point was observed before and after treatment (t=1.48, P>0.05). In Brimonidine group, IOP was 2.2±1.9 mm Hg lower than the baseline after one hour (t=3.856, P=0.003) and lasted for one hour. In Brinzolamide group, IOP was 1.4±1.1 mm Hg lower than the baseline after one hour (t=4.53, P=0.001) and lasted for 7h and the IOP declined most at 3h. In Latanaprost group, IOP was 2.1±1.3 mm Hg lower than the baseline after one hour (t=6.11, P=0.001) and lasted for one hour. CONCLUSION The IOP of guinea pig eyes is relatively stable compared to human eyes. In four reducing IOP medications, no significant effect of Carteolol is observed. Brinzolamide has the longest duration, while the Brimonidine has the shortest duration and the maximum level of treatment.
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Affiliation(s)
- Yue Di
- Department of Ophthalmology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China; Department of Ophthalmology, Jinshan Hospital, Fudan University, Shanghai 201508, China
| | - Xiu-Mei Luo
- Department of Ophthalmology, Jinshan Hospital, Fudan University, Shanghai 201508, China
| | - Tong Qiao
- Department of Ophthalmology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
| | - Na Lu
- Department of Radiology, Huashan Hospital North, Fudan University, Shanghai 201907, China
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Hodge C, Sutton G, Devasahayam R, Georges P, Treloggen J, Cooper S, Petsoglou C. The use of donor scleral patch in ophthalmic surgery. Cell Tissue Bank 2016; 18:119-128. [DOI: 10.1007/s10561-016-9603-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 11/17/2016] [Indexed: 12/17/2022]
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Rodriguez-Una I, Azuara-Blanco A, King AJ. Survey of glaucoma surgical preferences and post-operative care in the United Kingdom. Clin Exp Ophthalmol 2016; 45:232-240. [DOI: 10.1111/ceo.12846] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/29/2016] [Accepted: 10/04/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Ignacio Rodriguez-Una
- Department of Ophthalmology and Visual Sciences; Nottingham University Hospital; Nottingham UK
| | | | - Anthony J King
- Department of Ophthalmology and Visual Sciences; Nottingham University Hospital; Nottingham UK
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