Obstruction of aqueous humor outflow by cross-linked polyacrylamide microgels in bovine, monkey, and human eyes

A modified in vitro method for aqueous humor outflow studies in enucleated porcine eyes

The aim of this study was to develop and test a short-term in vitro method for aqueous humour outflow studies using enucleated porcine eyes. The method used was a modification of two methods that have previously been used: whole eyes and anterior segment cultures. The advantage of the model used in this study was that the anterior part of the eye, including the anterior and posterior chambers, remained intact as in whole enucleated eyes, but neither iridotomia nor trephination through the cornea was needed. The deepening of the anterior chamber during perfusion was avoided by regulating the "vitreal" pressure. Test compounds were administered topically or intracamerally to an anatomically normal anterior chamber. Fresh porcine eyes (n = 48) were sectioned at the equator, and the vitreous mass was carefully removed. This anterior bisection was bound around a specific plastic chamber, thus creating a closed eye. The anterior chamber was perfused at a pressure of 15 mmHg. The mean outflow rate in the nonmedicated eye group was 3.7 +/- 0.20 microL/min (mean +/- standard error of the mean), and it increased by 18% during 9 h owing to a wash-out effect. Compounds known to enhance the aqueous outflow were used for testing the validity of the preparation.

Monkey organ-cultured anterior segments: technique and response to H-7

In the intact primate eye in vivo, it may be difficult to determine whether an outflow facility response is due to direct effects on the trabecular meshwork or indirectly via an effect on ciliary muscle tone unless complicated surgical ciliary muscle disinsertion or isotope accumulation procedures are used. We established a monkey anterior segment organ culture system modeled after the human anterior segment organ culture system and determined its characteristics and response to H-7, an agent shown to increase trabecular outflow in vivo and in other organ culture systems. Outflow facility studies conducted using the monkey organ-cultured anterior segment system showed that: baseline values were comparable to those measured in vivo; washout occurred with time; the two-level constant pressure perfusion technique gave results comparable to the constant rate technique; species differences were found comparing baseline outflow facility and intraocular pressure in rhesus and cynomolgus monkey organ-cultured anterior segments; there was no effect of age on outflow facility in either species by one-way ANOVA; anterior segment exchange perfusion increased outflow facility if measured within 1 hr of the exchange; the magnitude of the response to H-7 was comparable to those reported in vivo and in other in vitro systems. The onset of the response to H-7 was delayed in most cases (day after H-7 exchange), compared to in vivo monkey studies (onset 6-9 min) and in vitro human and porcine organ culture systems (within 1 hr). Also the duration of the response (2-3 days from the onset) was longer than that found for in vitro human studies (1 day). Thus, the monkey organ-cultured anterior segment system can be used to determine the effects of pharmacological and biological agents on trabecular outflow.

Primate glaucoma models

The monkey model of ocular hypertension (OHT) with its resultant optic neuropathy closely reflects the optic neurodegeneration associated with human glaucoma. Utilization of the experimental glaucoma model (ExpG) in non-human primates (NHP) has led to advances in the understanding of aqueous humor dynamics, glaucomatous changes in the visual pathways from photoreceptors to the visual cortex, and anterior and posterior ocular segment pharmacological effects.

Ocular preparations: the formulation approach

The main aim of pharmacotherapeutics is the attainment of an effective drug concentration at the intended site of action for a sufficient period of time to elicit the response. A major problem being faced in ocular therapeutics is the attainment of an optimal concentration at the site of action. Poor bioavailability of drugs from ocular dosage forms is mainly due to the tear production, non-productive absorption, transient residence time, and impermeability of corneal epithelium. This article reviews: (1) the barriers that decrease the bioavailability of an ophthalmic drug; (2) the objectives to be considered in producing optimal formulations; and (3) the approaches being used to improve the corneal penetration of a drug molecule and delay its elimination from the eye. The focus of this review is on the recent developments in topical ocular drug delivery systems, the rationale for their use, their drug release mechanism, and the characteristic advantages and limitations of each system. In addition, the review attempts to give various analytical procedures including the animal models and other models required for bioavailability and pharmacokinetic studies. The latter can aid in the design and predictive evaluation of newer delivery systems. The dosage forms are divided into the ones which affect the precorneal parameters, and those that provide a controlled and continuous delivery to the pre- and intraocular tissues. The systems discussed include: (a) the commonly used dosage forms such as gels, viscosity imparting agents, ointments, and aqueous suspensions; (b) the newer concept of penetration enhancers, phase transition systems, use of cyclodextrins to increase solubility of various drugs, vesicular systems, and chemical delivery systems such as the prodrugs; (c) the developed and under-development controlled/continuous drug delivery systems including ocular inserts, collagen shields, ocular films, disposable contact lenses, and other new ophthalmic drug delivery systems; and (d) the newer trends directed towards a combination of drug delivery technologies for improving the therapeutic response of a non-efficacious drug. The fruitful resolution of the above-mentioned technological suggestions can result in a superior dosage form for both topical and intraocular ophthalmic application.

A comparison of Healon and Amvisc on the early postoperative pressure after extracapsular cataract extraction with implantation of posterior chamber lens

Two viscoelastic agents, Healon and Amvisc, both hyaluronic acids, were evaluated in two prospective, randomized and masked studies in order to compare the effects of the viscoelastics and timolol (Blocadren ) on the early postoperative intraocular pressure (IOP) after planned extracapsular cataract extraction with implantation of a posterior chamber lens. The study protocols were similar, especially with regard to the sample size, pre-, per- and postoperative management and sampling. The IOP was measured preoperatively, 3-6 and 24 h postoperatively. The testing of Amvisc revealed that aspiration or non-aspiration of Amvisc at the end of surgery was of little importance for the IOP, and that timolol significantly reduced the IOP 3-6 h postoperatively in the order of about 8 mmHg. The postoperative IOP was lower for Amvisc than for Healon only when the viscoelastic material was aspirated and topical timolol was administered. In all the other groups there were no significant differences between the viscoelastics as far as the postoperative pressure was concerned. Multiple regression revealed a marked pressure reducing effect of timolol 3-6 h postoperatively in both groups, but no effect was observed 24 h postoperatively. The two viscoelastic agents showed minor effect on the IOP both 3-6 and 24 h postoperatively.