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Oliver C Steinbach
The present industry update covers the period 1-30 June 2017, with information sourced from company press releases, regulatory and patent agencies as well as scientific literature. The combination of drug and devices such as improved, safer injectables (see various market reports, companies Adamis and Baxter), patches (Microdermis) and (nano)carriers are moving increasingly from the R&D stage into clinical trials and toward the market. This addresses increased safety and effectiveness requirements, limiting physico-chemical properties of active ingredients, cost-effectiveness and patient comfort through ease of use...
October 2017: Therapeutic Delivery
Michele Figus, Chiara Posarelli, Andrea Passani, Timothy G Albert, Francesco Oddone, Angela Tindara Sframeli, Marco Nardi
The supraciliary space is a physiological route for aqueous humor outflow located anteriorly between the outer surface of the ciliary body and the internal surface of the sclera. Posteriorly, the suprachoroidal space is located between the choroid and the internal surface of the sclera. These spaces have been targeted as suitable and helpful pathways for glaucoma treatment, alternatives to the traditional subconjunctival space. The subconjunctival surgical pathway is affected by several limitations such as poor cosmesis, a lifetime risk for endophthalmitis, and an unpredictable wound healing response...
November 2017: Survey of Ophthalmology
Brian A Francis, Handan Akil, Benjamin B Bert
In primary open-angle glaucoma, the site of greatest resistance to aqueous outflow is thought to be the trabecular meshwork (TM) and inner wall of Schlemm's canal. Augmentation of the conventional (trabecular) outflow pathway can facilitate physiologic outflow and subsequently lower intraocular pressure. The most recent approach to enhancing the conventional outflow pathway is via an internal approach to the TM and Schlemm's canal. Ab interno Schlemm's canal surgery includes 4 novel surgical approaches: (1) removal of the TM and inner wall of Schlemm's canal by an internal approach (ab interno trabeculectomy), (2) implantation of a microstent to bypass the TM, (3) disruption of the TM and inner wall of Schlemm's canal via an internal approach (ab interno trabeculotomy), and (4) dilation of Schlemm's canal via an internal approach (ab interno canaloplasty)...
2017: Developments in Ophthalmology
Nathan M Kerr, Jing Wang, Keith Barton
Recently, many new devices and procedures have been developed to lower intraocular pressure in a less invasive and purportedly safer manner than traditional glaucoma surgery. These new devices might encourage an earlier transition to surgery and reduce the long-term commitment to topical glaucoma medications with their associated compliance and intolerance issues. Although often seen as an adjunct to cataract surgery, a growing body of evidence suggests that primary minimally invasive glaucoma surgery may be a viable initial treatment option...
May 2017: Clinical & Experimental Ophthalmology
Pedro Arriola-Villalobos, Jose Maria Martinez-de-la-Casa, David Diaz-Valle, Laura Morales-Fernandez, Cristina Fernandez-Perez, Julian Garcia-Feijoo
Purpose. To evaluate the long-term efficacy and safety of the iStent inject device (Glaukos Corporation, Laguna Hills, CA) combined with phacoemulsification in patients with coexistent cataract and open-angle glaucoma or ocular hypertension (OHT). Methods. A prospective, uncontrolled, nonrandomized, interventional case series study was conducted in patients with both mild or moderate open-angle glaucoma or OHT and cataract. Patients underwent cataract surgery along with the implant of two iStent inject devices...
2016: Journal of Ophthalmology
Kateki Vinod, Steven J Gedde
PURPOSE OF REVIEW: This article reviews recent studies evaluating the efficacy and complication profiles of novel glaucoma procedures promoting aqueous outflow. RECENT FINDINGS: Literature from the 2015 to 2016 review period includes abundant data regarding new and emerging glaucoma procedures. Notable findings from recent randomized clinical trials include titratability of intraocular pressure with multiple trabecular microbypass stents (iStent; Glaukos, Laguna Hills, California, USA) and greater reduction in intraocular pressure and medication usage following intracanalicular scaffolding (Hydrus Microstent; Ivantis Inc...
March 2017: Current Opinion in Ophthalmology
Richard Lindstrom, Richard Lewis, Dana M Hornbeak, Lilit Voskanyan, Jane Ellen Giamporcaro, John Hovanesian, Steven Sarkisian
INTRODUCTION: The study objective was to evaluate the intraocular pressure (IOP) and medication-lowering effect of 2 second-generation trabecular micro-bypass stents in eyes with open-angle glaucoma (OAG) on one preoperative medication. METHODS: Fifty-seven qualified phakic eyes with OAG on 1 medication, preoperative medicated IOP of 18-30 mmHg, and preoperative unmedicated (post-washout) IOP of 22-38 mmHg underwent implantation of 2 second-generation trabecular micro-bypass stents in a standalone procedure...
November 2016: Advances in Therapy
Leonard K Seibold, Kevin M Gamett, Jeffrey B Kennedy, Matthew J Mulvahill, Miranda E Kroehl, Jeffrey R SooHoo, Mina B Pantcheva, Malik Y Kahook
PURPOSE: To study the effect of combined phacoemulsification cataract surgery and iStent (trabecular microbypass stent) implantation on intraocular pressure (IOP) and medication use in open-angle glaucoma (OAG) patients with a low mean preoperative IOP. SETTING: University of Colorado Health Eye Center, Aurora, Colorado, USA. DESIGN: Retrospective case series. METHODS: Treatment outcomes analyzed included IOP, medication use, and corrected distance visual acuity (CDVA)...
September 2016: Journal of Cataract and Refractive Surgery
Steven D Vold, Lilit Voskanyan, Manfred Tetz, Gerd Auffarth, Imran Masood, Leon Au, Iqbal Ike K Ahmed, Hady Saheb
PURPOSE: To examine outcomes through 36 months in phakic eyes with newly diagnosed primary open-angle glaucoma (POAG) naïve to therapy randomized to treatment with two trabecular micro-bypass stents or topical prostaglandin. METHODS: Subjects with POAG naïve to therapy, with intraocular pressure (IOP) ≥21 and ≤40 mmHg, were randomized to implantation of two stents or travoprost. Additional medication was to be prescribed post-treatment for elevated IOP or glaucomatous optic nerve findings...
December 2016: Ophthalmology and Therapy
Hidenoba Tanihara, Ikuko Abe
It is said that the description of an ocular disorder related to the color of the sea in the Hippocratic Corpus is the oldest medical reference to glaucoma. In the early Edo period in Japan, the Books of Secrets of the Majima school, describe a disorder called aosokohi. This nomenclature is believed to be based upon the Five Elements' Theory (Wu-Xing Thought)in ancient China, which assigned five colors for intraocular disorders ("naisho/sokohi" in Japanese), blue ("ao" in Japanese), red, yellow, white and black...
May 2016: Nippon Ganka Gakkai Zasshi
Tobias H Neuhann
PURPOSE: To evaluate long-term safety and efficacy of iStent trabecular micro-bypass stent implantation during cataract surgery in patients with primary open-angle, pseudo-exfoliation glaucoma, ocular hypertension, or secondary or post-traumatic glaucoma. SETTING: AaM Augenklinik am Marienplatz, Munich, Germany. DESIGN: Prospective, open-label, non-randomized study. METHODS: Preoperative and postoperative evaluations included intra-ocular pressure (IOP), topical ocular hypotensive medication use, cup/disc ratio, corrected-distance visual acuity (CDVA), complications, and adverse events...
December 2015: Journal of Cataract and Refractive Surgery
Madhvi Deol, Joshua R Ehrlich, Mitsugu Shimmyo, Nathan M Radcliffe
PURPOSE: To evaluate the relationship between baseline corneal hysteresis (CH) and the change in intraocular pressure (IOP) before and after cataract extraction in patients without glaucoma. SETTING: Private practice, New York City, New York, USA. DESIGN: Retrospective cohort study. METHODS: Charts of consecutive patients who had phacoemulsification cataract extraction with posterior chamber intraocular lens implantation were analyzed...
June 2015: Journal of Cataract and Refractive Surgery
Christopher T Leffler, Stephen G Schwartz, Tamer M Hadi, Ali Salman, Vivek Vasuki
To the ancient Greeks, glaukos occasionally described diseased eyes, but more typically described healthy irides, which were glaucous (light blue, gray, or green). During the Hippocratic period, a pathologic glaukos pupil indicated a media opacity that was not dark. Although not emphasized by present-day ophthalmologists, the pupil in acute angle closure may appear somewhat green, as the mid-dilated pupil exposes the cataractous lens. The ancient Greeks would probably have described a (normal) green iris or (diseased) green pupil as glaukos...
2015: Clinical Ophthalmology
Iqbal Ike K Ahmed, L Jay Katz, David F Chang, Eric D Donnenfeld, Kerry D Solomon, Lilit Voskanyan, Thomas W Samuelson
PURPOSE: To evaluate the intraocular pressure (IOP) lowering effect of 2 trabecular microbypass stents and postoperative travoprost in patients with open-angle glaucoma (OAG) not controlled on 2 medications preoperatively. SETTING: S.V. Malayan Ophthalmology Centre, Yerevan, Armenia. DESIGN: Prospective open-label nonrandomized study. METHODS: This prospective pilot study involved 39 qualified phakic patients with OAG, medicated IOP between 18 mm Hg and 30 mm Hg, and unmedicated baseline (after washout) IOP between 22 mm Hg and 38 mm Hg...
August 2014: Journal of Cataract and Refractive Surgery
Andrew K Bailey, Steven R Sarkisian, Steven D Vold
UNLABELLED: Although glaucoma filtration surgery options are generally effective means of surgically lowering intraocular pressure (IOP), complications have driven innovators to develop novel approaches to the lowering of IOP. Using the suprachoroidal space has been one novel way to avoid these complications. This article reviews how recent innovation has exploited this space to lower IOP. FINANCIAL DISCLOSURE: Dr. Sarkisian and Dr. Vold have received research support from Transcend Medical, Inc...
August 2014: Journal of Cataract and Refractive Surgery
Swarup S Swaminathan, Dong-Jin Oh, Min Hyung Kang, Douglas J Rhee
UNLABELLED: The elevated intraocular pressure (IOP) of primary open-angle glaucoma is caused by impaired outflow of aqueous humor through the trabecular meshwork. Within the juxtacanalicular region, alterations of both extracellular matrix homeostasis and the cellular tone of trabecular meshwork endothelial and the inner wall of Schlemm canal cells affect outflow. Newer pharmacologic agents that target trabecular meshwork and Schlemm canal cell cytoskeleton lower IOP. Aqueous drainage occurs nonhomogenously with greater flow going through certain portions of the TM and less going through other portions-a concept known as segmental flow, which is theoretically the result of outflow being dependent on the presence of discrete pores within Schlemm canal...
August 2014: Journal of Cataract and Refractive Surgery
Kendall S Hunter, Todd Fjield, Hal Heitzmann, Robin Shandas, Malik Y Kahook
Micro-invasive glaucoma surgery with the Glaukos iStent® or iStent inject® (Glaukos Corporation, Laguna Hills, CA, USA) is intended to create a bypass through the trabecular meshwork to Schlemm's canal to improve aqueous outflow through the natural physiologic pathway. While the iStent devices have been evaluated in ex vivo anterior segment models, they have not previously been evaluated in whole eye perfusion models nor characterized by computational fluid dynamics. Intraocular pressure (IOP) reduction with the iStent was evaluated in an ex vivo whole human eye perfusion model...
2014: Clinical Ophthalmology
Lilit Voskanyan, Julián García-Feijoó, Jose I Belda, Antonio Fea, Anselm Jünemann, Christophe Baudouin
INTRODUCTION: Micro-invasive glaucoma surgical implantation of trabecular micro-bypass stents, previously shown to be safe and effective for open-angle glaucoma (OAG) subjects during cataract surgery, was considered for evaluation as a sole procedure. The aim of this study was to evaluate the safety and intraocular pressure (IOP)-lowering efficacy after ab interno implantation of two Glaukos Trabecular Micro-Bypass iStent inject second generation devices in subjects with OAG. This study was performed at sites in France, Germany, Italy, Republic of Armenia, and Spain...
February 2014: Advances in Therapy
Pedro Arriola-Villalobos, José Maria Martínez-de-la-Casa, David Díaz-Valle, Sara E García-Vidal, Cristina Fernández-Pérez, Julián García-Sánchez, Julián García-Feijoó
AIMS: To evaluate the mid-term efficacy and safety of the GTS-400-iStent combined with phacoemulsification in patients with cataract and open-angle glaucoma (OAG) or ocular hypertension (OHT). METHODS: Prospective, non-comparative, uncontrolled, interventional case series study. Subjects underwent phacoemulsification and two GTS-400 implantation. Efficacy outcomes: intraocular pressure (IOP) and antiglaucoma medications. Safety outcomes: complications, best-corrected visual acuity and endothelial cell count (ECC)...
October 2013: British Journal of Ophthalmology
Graham W Belovay, Abdulla Naqi, Brian J Chan, Mahmoud Rateb, Iqbal Ike K Ahmed
PURPOSE: To evaluate the efficacy of multiple trabecular micro-bypass stents combined with cataract surgery in patients with open-angle glaucoma (OAG) and cataract. SETTING: Private practice, Mississauga, Ontario, Canada. DESIGN: Comparative case series. METHODS: Eyes with OAG had implantation of 2 or 3 micro-bypass stents with concurrent cataract surgery and follow-up through 1 year. Efficacy measures were intraocular pressure (IOP) and topical ocular hypotensive medication use...
November 2012: Journal of Cataract and Refractive Surgery
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