Hypotonous Maculopathy After Trabeculectomy With Subconjunctival 5-Fluorouracil

Stamper, Robert L.; McMenemy, Matthew G.; Lieberman, Marc F.

doi:10.1016/s0002-9394(14)74481-2

Cited by 208 publications

(97 citation statements)

References 12 publications

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“…[10][11][12] This study describes for the first time a more physiological method of inhibiting postsurgical ocular scarring with modified second-generation phosphorothioate antisense oligonucleotides against TGF-b. We suggest that TGF-b antisense OGN offer a safer and more controlled strategy than those currently available for modulating scarring not only in the eye, but throughout the body.…”

Section: Discussionmentioning

confidence: 99%

“…8, 9 The introduction of wound-healing modulators has greatly improved glaucoma surgery results, but unfortunately, their use is limited by severe and potentially blinding complications. [10][11][12] Transforming growth factor-b (TGF-b) is known to be the most potent growth factor involved in wound healing throughout the body. [13][14][15][16] In the eye, all three human isoforms (TGF-b1, TGF-b2 and TGF-b3) have been found although TGF-b2 appears predominant.…”

Section: Introductionmentioning

confidence: 99%

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Novel antisense oligonucleotides targeting TGF-β inhibit in vivo scarring and improve surgical outcome

Cordeiro¹,

Mead²,

Ali

et al. 2003

Gene Ther

155

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The scarring response is an important factor in many diseases throughout the body. In addition, it is a major problem in influencing results of surgery. In the eye, for example, post-operative scarring can determine the outcome of surgery. This is particularly the case in the blinding disease glaucoma, where several anti-scarring regimens are currently used to improve glaucoma surgery results, but are of limited use clinically because of severe complications. We have recently identified transforming growth factor-b (TGF-b) as a target for post-operative anti-scarring therapy in glaucoma, and now report the first study of novel secondgeneration antisense phosphorothioate oligonucleotides against TGF-b in vivo. Single applications of a TGF-b OGN at the time of surgery in two different animal models closely related to the surgical procedure performed in glaucoma patients, significantly reduced post-operative scarring (Po0.05) and improved surgical outcome. Our findings suggest that TGF-b antisense oligonucleotides have potential as a new therapy for reducing post-surgical scarring. Its long-lasting effects after only a single administration at the time of surgery make it particularly attractive clinically. Furthermore, although we have shown this agent to be useful in the eye, it could have widespread applications anywhere in the body where the wound-healing response requires modulation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Novel antisense oligonucleotides targeting TGF-β inhibit in vivo scarring and improve surgical outcome

Cordeiro¹,

Mead²,

Ali

et al. 2003

Gene Ther

155

View full text Add to dashboard Cite

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“…98,99 It has been suggested that a thin sclera predisposes an eye to postoperative hypotony. [100][101][102] The high prevalence of myopia (and hence thinner sclera) in the Chinese population may be relevant in this respect. 103 The thickness of the sclera at the point of exposure to antimetabolite and subsequent damage to the ciliary body also needs to be considered.…”

Section: Characteristics Of East Asian Eyesmentioning

confidence: 99%

“…The association between myopia and POAG have been reported previously, 111,112 as have the challenges of filtration surgery on the highly myopic eye. 101 More recently, interest has focused on the associations between myopia, ocular dimensions, and PACG. PACG occurs more often in eyes with shallow anterior chambers and short axial lengths.…”

Section: Eyementioning

confidence: 99%

A review of trabeculectomy in East Asian people—the influence of race

Husain

Clarke

Seah

et al. 2004

Eye

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Glaucoma is the leading cause of irreversible blindness worldwide. East Asians account for approximately half of all glaucoma sufferers. It is likely that trabeculectomy will be needed for many of these people as the intraocular pressure is to be maintained at a satisfactorily low level. The eyes of East Asian people differ in some aspects from those of other races. This review describes the natural history of the eye after trabeculectomy in East Asians.

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“…Hypotonous maculopathy may occur early after trabeculectomy with mitomycin C (Suñ er et al 1997) and is the most common early complication requiring repeated operation (Perkins et al 1998). Treatment of postoperative hypotonous maculopathy after glaucoma filtration procedures often is reportedly unsuccessful at restoring initial visual acuity (Jampel et al 1992;Stamper et al 1992). When visual acuity was restored to eyes with hypotonous maculopathy, it was achieved by increasing the intraocular pressure (IOP) to higher than normal levels (Cohen et al 1995).…”

mentioning

confidence: 99%

Autologous blood injection for marked overfiltration early after trabeculectomy with mitomycin C

Okada

Tsukamoto

Masumoto

et al. 2001

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: After trabeculectomy with mitomycin C, extremely low intraocular pressure (IOP) with excess filtration may cause hypotonous maculopathy in the early postoperative period. We evaluated the effect of injecting autologous blood on reversing early postoperative marked hypotony after trabeculectomy with mitomycin C. Methods: Trabeculectomy with mitomycin C was performed in 258 eyes between 1994 and 1998. Peribleb autologous blood injection was performed in five eyes in which pressure patches were ineffective in reversing excess filtration. Approximately 0.1 to 0.3 ml of whole unclotted blood was slowly injected at least 3 mm from the edge of the flap using a sterile 27-gauge needle. Results: None of these eyes developed hypotonous maculopathy after injection. After a mean 31-month follow-up, all eyes had well-controlled IOP and visual acuity in three eyes was much improved. Postoperative complications included mild IOP elevation in one eye treated with laser suturelysis, and fibrinous pupillary membrane in one eye. Conclusion: In the early postoperative period, autologous blood injection is effective in reversing excess filtration.

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Hypotonous Maculopathy After Trabeculectomy With Subconjunctival 5-Fluorouracil

Cited by 208 publications

References 12 publications

Novel antisense oligonucleotides targeting TGF-β inhibit in vivo scarring and improve surgical outcome

Novel antisense oligonucleotides targeting TGF-β inhibit in vivo scarring and improve surgical outcome

A review of trabeculectomy in East Asian people—the influence of race

Autologous blood injection for marked overfiltration early after trabeculectomy with mitomycin C

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