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Cai M, Luo W, Feng K, Chen Y, Yi L, Zhu X, He J, Liu H, Hutnik C, Wang Y, Li X, Xie L. Intraocular pressure control efficacy and safety of HA-Mg glaucoma drainage plate implantation in the anterior chamber of rabbit eyes. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2024; 35:37. [PMID: 38916635 PMCID: PMC11199312 DOI: 10.1007/s10856-024-06806-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 06/04/2024] [Indexed: 06/26/2024]
Abstract
The current clinical application of glaucoma drainage devices is made of non-degradable materials. These non-degradable drainage devices often trigger inflammatory responses and scar proliferation, possibly leading to surgical failure. We developed a biodegradable material hydroxyapatite-coated magnesium (HA-Mg) as a glaucoma drainage device. Twelve New Zealand white rabbits were randomly assigned to three groups: HA-Mg drainage plate group (6 right eyes), trabeculectomy group (6 right eyes), and control group (12 left eyes). Results showed that all HA-Mg drainage plates were completely degraded ~4 months postoperatively. At the 5th month postoperatively, there was no statistical difference in the corneal endothelium density between the HA-Mg drainage plate group and the control group (p = 0.857). The intraocular pressure (IOP) level in the HA-Mg drainage plate implantation group was lower than in the other two groups. The trypan blue dye still drained from the anterior chamber to the subconjunctiva 5 months after HA-Mg drainage plate implantation. HE staining revealed the scleral linear aqueous humor drainage channel and anterior synechia were observed after drainage plate completely degraded, with no obvious infiltration with the inflammatory cells. This study showed the safety and efficacy of HA-Mg glaucoma drainage plate in controlling IOP after implantation into the anterior chamber of rabbit eyes.
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Affiliation(s)
- Mingming Cai
- Department of Ophthalmology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
- Department of Ophthalmology, Beibei Hospital of Chongqing Medical University, Chongqing, 400700, China
| | - Wangdu Luo
- Department of Ophthalmology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Kevin Feng
- Department of Basic Medical Science, Western University, London, ON, Canada
| | - Yi Chen
- School of Materials Science and Engineering, National Engineering and Technology Research Center for Magnesium Alloy Materials, Chongqing University, Chongqing, 400045, China
| | - Lin Yi
- Department of Ophthalmology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Xiaomin Zhu
- Department of Ophthalmology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Ju He
- Department of Ophthalmology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China
| | - Hong Liu
- Department of Ophthalmology, Ivey Eye Institute, St. Joseph's Health Care London, Western University, London, ON, Canada
| | - Cindy Hutnik
- Department of Ophthalmology, Ivey Eye Institute, St. Joseph's Health Care London, Western University, London, ON, Canada
| | - Yong Wang
- School of Materials Science and Engineering, National Engineering and Technology Research Center for Magnesium Alloy Materials, Chongqing University, Chongqing, 400045, China
| | - Xiangji Li
- Department of Ophthalmology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China.
| | - Lin Xie
- Department of Ophthalmology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China.
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Jin Y, Jin W, Sun Q, Li N, Jiang M, Liu Y, Sun L. Role of the chloride channel blocker in the formation of filtering tract scars after glaucoma surgery in rats. Clin Exp Pharmacol Physiol 2023; 50:806-814. [PMID: 37452725 DOI: 10.1111/1440-1681.13803] [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: 11/19/2022] [Revised: 05/09/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023]
Abstract
Filtration surgery is commonly performed for glaucoma treatment to reduce intraocular pressure (IOP); however, scarring of the filtering bleb is the main cause of failure. In this study, we evaluated the effects of the chloride channel blocker 5-nitro-2-(3-phenylpropylamino)benzoic acid (NPPB) on scar formation in filtering blebs. A glaucoma filtering surgery model was generated using Sprague-Dawley rats, divided into the control and NPPB groups receiving injections of different NPPB concentrations. The IOP of all rats decreased 1-day post-surgery and gradually increased afterward. However, IOP in rats from the NPPB groups recovered more slowly than that of the control group rats. In addition, the area and survival times of filtering blebs in rats from the NPPB groups were substantially larger and longer than those in the control group. Twenty-eight days after surgery, the protein and mRNA expression of collagen I, fibronectin and α-smooth muscle actin in the filtering area of rats from the NPPB groups were significantly lower than that in the control group rats. Collectively, our study demonstrates that NPPB inhibits filtering bleb scar formation, maintains filtering bleb morphology and prolongs filtering bleb survival time by inhibiting the differentiation of conjunctival fibroblasts and extracellular matrix synthesis.
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Affiliation(s)
- Yujiao Jin
- Department of Ophthalmology, The Affiliated Hospital of Yanbian University, Yanji, China
| | - Weiyi Jin
- Department of Ophthalmology, The Affiliated Hospital of Yanbian University, Yanji, China
| | - Qiushuang Sun
- Department of Ophthalmology, The Affiliated Hospital of Yanbian University, Yanji, China
| | - Nan Li
- Department of Ophthalmology, The Affiliated Hospital of Yanbian University, Yanji, China
| | - Meiling Jiang
- Department of Ophthalmology, The Affiliated Hospital of Yanbian University, Yanji, China
| | - Yinfeng Liu
- Department of Ophthalmology, The Affiliated Hospital of Yanbian University, Yanji, China
| | - Lixia Sun
- Department of Ophthalmology, The Affiliated Hospital of Yanbian University, Yanji, China
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Helmers G, Munteanu C, Löw U, Seitz B. [Trabeculectomy with mitomycin C and Ologen® implant in comparison to classical trabeculectomy]. DIE OPHTHALMOLOGIE 2023; 120:20-26. [PMID: 35925352 DOI: 10.1007/s00347-022-01686-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/30/2022] [Accepted: 06/17/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Trabeculectomy (TE) with mitomycin C (MMC) is considered the gold standard in glaucoma surgery. A new modification is the use of an Ologen® implant (AEON Astron Europe B.V., Leiden, Netherlands) during TE, which was analyzed and compared to the standard TE in this retrospective study. PATIENTS AND METHODS On 70 eyes Ologen® was applied during surgery (group 2), whereas 98 eyes were operated on without the implant (group 1). Both surgical procedures were compared regarding the efficiency of lowering the intraocular pressure (IOP), the number of glaucoma medications, the rate of complications and follow-up treatment. Data were collected up to 24 months after surgery. RESULTS In group 1 the IOP was lowered from 28.0 mmHg (95% confidence interval, CI 26.6-29.4 mmHg) to 16.0 mmHg (14.0-18.1) after 24 months. In group 2, the pressure dropped from 28.5 mmHg (26.8-30.1) to 14.3 mmHg (11.7-17.0). The IOP reduction was significant in both groups (p < 0.001), there was no significant difference between the groups (p > 0.05). Glaucoma-related follow-up treatments were performed more often in group 1 but the difference was not significant. CONCLUSION Both procedures significantly lower the IOP and the number of glaucoma medications. For our cases, TE with Ologen® and MMC is considered to be superior to TE with MMC regarding the lower rates of follow-up treatments as it is less time-consuming for the patients and the clinic.
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Affiliation(s)
- Gloria Helmers
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes (UKS), Kirrberger Straße 100, Gebäude 22, 66424, Homburg/Saar, Deutschland.
| | - Cristian Munteanu
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes (UKS), Kirrberger Straße 100, Gebäude 22, 66424, Homburg/Saar, Deutschland
| | - Ursula Löw
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes (UKS), Kirrberger Straße 100, Gebäude 22, 66424, Homburg/Saar, Deutschland
| | - Berthold Seitz
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes (UKS), Kirrberger Straße 100, Gebäude 22, 66424, Homburg/Saar, Deutschland
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Brzheskiy VV. [Modern possibilities of pathogenetically oriented therapy for dry eye syndrome]. Vestn Oftalmol 2023; 139:95-103. [PMID: 37067938 DOI: 10.17116/oftalma202313902195] [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: 04/18/2023]
Abstract
In recent years, anti-inflammatory therapy has become a significant part of the complex approach to treatment of patients with dry eye syndrome (DES), with cyclosporine preparations becoming increasingly important in the structure of the therapy. Taking into account the immunosuppressive effect of cyclosporine A, which is realized through hindering the activation of T-lymphocytes in the tissues of the ocular surface, its topical application in DES has a pronounced pathogenetic focus. Numerous clinical studies have shown that instillations of cyclosporine into the conjunctival cavity contribute to an increase in total tear production, as well as recovery of the density of goblet cells in the conjunctiva of DES patients. The positive effect of cyclosporine A instillations has been convincingly demonstrated in the complex therapy of patients with vernal and atopic corneal conjunctivitis, Thygeson's superficial punctate keratitis, autoimmune keratitis, meibomian gland dysfunction, etc. However, one significant problem associated with cyclosporine A instillations is the irritating effect of the drug. That prompted the development of a drug that is safe and tolerable during instillations into the conjunctival cavity - preservative-free 0.1% cyclosporine A labelled Ikervis (Santen, Japan). The drug carrier is artificial tear Cationorm (Santen), which has an advantage of stabilizing the tear film and protecting the ocular surface from the irritating effect of cyclosporine. According to numerous clinical studies, Ikervis instillations can improve the effectiveness of complex therapy in patients with DES (especially secondary to Sjögren syndrome, Stevens-Johnson syndrome, graft-versus-host disease), with allergic diseases of the cornea and conjunctiva (spring, atopic corneal conjunctivitis), with corneal transplant disease, and other similar conditions. The high efficacy and safety of Ikervis constitute the reason to recommend it for wide clinical use.
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Affiliation(s)
- V V Brzheskiy
- Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
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