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Rykov SO, Shargorodska IV, Novak LP, Lіchman LY, Luhovskyi OF, Sharhorodskyi SV, Sas OS. Benefits of a combined surgical technique for patients with secondary neovascular glaucoma. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:1011-1017. [PMID: 39008591 DOI: 10.36740/wlek202405121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
OBJECTIVE Aim: To assess the effectiveness and safety of the proposed surgical technique for treating secondary neovascular glaucoma. PATIENTS AND METHODS Materials and Methods: We examined 28 eyes of 28 patients (16 women and 12 men), aged 46}7,2 years, with secondary neovascular glaucoma. All patients underwent a comprehensive ophthalmological examination before and during treatment. Two-stage treatment was applied to all patients. At the first stage - performed an advanced technique of non-penetrating deep sclerectomy while administering anti-VEGF (anti-vascular endothelial growth factor) intravitreal or intracameral injections. At the second - we performed externalization of Schlemm's canal followed by YAG laser trabeculectomy. Statistical analysis of the results was used the SPSS v. 11.0, MedStat v.15.1 software package for medical and biological research. RESULTS Results: The proposed surgical technique, leads to a gradual decrease in intraocular pressure (IOP) and regression of the iris and anterior chamber angle neovascularization. The postoperative course was uneventful for all the patients. In the early postoperative period, the IOP was observed to be normalized in all the eyes. The IOP ranged from 12 to 16 mm Hg. The neovascularization regression occurred (in 100 % of cases) within 5-7 days. CONCLUSION Conclusions: Gradual reduction of IOP reduces intraoperative complications. Intravitreal or intracameral injections of anti-proliferative agents contribute to the regression of neovascularization and further gradual reduction of IOP. Performing a laser trabeculectomy in the area where a non-penetrating deep sclerectomy was previously performed creates new pathways for the outflow of intraocular fluid from the anterior chamber and reduces the risks of reintervention.
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Affiliation(s)
| | | | | | - Lada Yu Lіchman
- SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE
| | - Oleksandr F Luhovskyi
- NATIONAL TECHNICAL UNIVERSITY OF UKRAINE ≪IGOR SIKORSKY KYIV POLYTECHNIC INSTITUTE≫, KYIV, UKRAINE
| | - Serhii V Sharhorodskyi
- NATIONAL TECHNICAL UNIVERSITY OF UKRAINE ≪IGOR SIKORSKY KYIV POLYTECHNIC INSTITUTE≫, KYIV, UKRAINE
| | - Olha S Sas
- BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE
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Prognostic Evaluation of Vitrectomy Assisted by Lucentis in Diabetic Retinopathy and Neovascular Glaucoma. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:4127293. [PMID: 35958912 PMCID: PMC9359820 DOI: 10.1155/2022/4127293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022]
Abstract
For verifying the prognosis of Lucentis-assisted vitrectomy (PPV) in diabetic retinopathy (DR) and neovascular glaucoma (NVG), a retrospective analysis of DR and NVG patients who were admitted to our hospital from July 2019 to December 2020 was conducted. According to the treatment protocol, subjects who had PPV intervention were in the control group (CG; n = 38) and those receiving Lucentis adjunctive PPV were included in the intervention group (RG; n = 40). The indicators between groups were listed: treatment success rate, postoperative complication rate, surgical outcome indicators, BCVA, intraocular pressure (IOP) change, foveal thickness, and VEGF level in aqueous humor. Indicators in RG were obviously higher than in CG, such as treatment success rate and surgical outcome indicators. Conversely, lower postoperative complication rate, postoperative BCVA, IOP, retinal fovea thickness, and VEGF level in aqueous humor were found in RG than in CG. Therefore, the study reached the following conclusions about vitrectomy assisted by Lucentis: (1) it effectively increases the success rate of treatment, decreases postoperative complications as well as surgical risks, and improves patients' vision; (2) it promotes the recovery of IOP, reduces macular edema and VEGF levels in aqueous humor, and inhibits the neonatal formation of blood vessels. It is finally confirmed that Lucentis adjuvant PPV in the treatment of DR complicated with NVG is safe and feasible.
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Zhang T, Jin X, Zhang N, Jiao X, Ma Y, Liu R, Liu B, Li Z. Targeted drug delivery vehicles mediated by nanocarriers and aptamers for posterior eye disease therapeutics: barriers, recent advances and potential opportunities. NANOTECHNOLOGY 2022; 33:162001. [PMID: 34965522 DOI: 10.1088/1361-6528/ac46d5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
Nanomedicine and aptamer have excellent potential in giving play to passive and active targeting respectively, which are considered to be effective strategies in the retro-ocular drug delivery system. The presence of closely adjoined tissue structures in the eye makes it difficult to administer the drug in the posterior segment of the eye. The application of nanomedicine could represent a new avenue for the treatment, since it could improve penetration, achieve targeted release, and improve bioavailability. Additionally, a novel type of targeted molecule aptamer with identical objective was proposed. As an emerging molecule, aptamer shows the advantages of penetration, non-toxicity, and high biocompatibility, which make it suitable for ocular drug administration. The purpose of this paper is to summarize the recent studies on the effectiveness of nanoparticles as a drug delivery to the posterior segment of the eye. This paper also creatively looks forward to the possibility of the combined application of nanocarriers and aptamers as a new method of targeted drug delivery system in the field of post-ophthalmic therapy.
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Affiliation(s)
- Tingting Zhang
- State Key Laboratory of Component-based Chinese Medicine, Haihe Laboratory of Modern Chinese Medicine, College of Pharmaceutical Engineering of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, 10 Poyang Lake Road, West Zone of Tuanbo New City, Jinghai District, Tianjin 301617, People's Republic of China
| | - Xin Jin
- Military Medicine Section, Logistics University of Chinese People's Armed Police Force, 1 Huizhihuan Road, Dongli District, Tianjin 300309, People's Republic of China
| | - Nan Zhang
- State Key Laboratory of Component-based Chinese Medicine, Haihe Laboratory of Modern Chinese Medicine, College of Pharmaceutical Engineering of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, 10 Poyang Lake Road, West Zone of Tuanbo New City, Jinghai District, Tianjin 301617, People's Republic of China
| | - Xinyi Jiao
- State Key Laboratory of Component-based Chinese Medicine, Haihe Laboratory of Modern Chinese Medicine, College of Pharmaceutical Engineering of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, 10 Poyang Lake Road, West Zone of Tuanbo New City, Jinghai District, Tianjin 301617, People's Republic of China
| | - Yuanyuan Ma
- State Key Laboratory of Component-based Chinese Medicine, Haihe Laboratory of Modern Chinese Medicine, College of Pharmaceutical Engineering of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, 10 Poyang Lake Road, West Zone of Tuanbo New City, Jinghai District, Tianjin 301617, People's Republic of China
| | - Rui Liu
- State Key Laboratory of Component-based Chinese Medicine, Haihe Laboratory of Modern Chinese Medicine, College of Pharmaceutical Engineering of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, 10 Poyang Lake Road, West Zone of Tuanbo New City, Jinghai District, Tianjin 301617, People's Republic of China
| | - Boshi Liu
- State Key Laboratory of Component-based Chinese Medicine, Haihe Laboratory of Modern Chinese Medicine, College of Pharmaceutical Engineering of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, 10 Poyang Lake Road, West Zone of Tuanbo New City, Jinghai District, Tianjin 301617, People's Republic of China
| | - Zheng Li
- State Key Laboratory of Component-based Chinese Medicine, Haihe Laboratory of Modern Chinese Medicine, College of Pharmaceutical Engineering of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, 10 Poyang Lake Road, West Zone of Tuanbo New City, Jinghai District, Tianjin 301617, People's Republic of China
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