Skip to content

AIOC2020 GP096 T1 Dr Mayuri Khamar New Horizones in Glaucoma Management

  • by

A verizon demand of glaucoma management results in a constant search of an avenue to improve upon existing treatment management and innovative newer options so today i am going to talk on what are the new horizons that we have seen during this time the sustained-release implants in the retinal diseases have been causing ripples since its inception and will such

Modality bring shift paradigm in the glaucoma management that we are going to talk on this to share this what is brewing in the glaucoma management in this regard after 20 years we are now going to have to no class of drugs which are approved by us fda this year the netis rudl 0.02% and latin approach viewed on 0.0 24 percent has no while approaching the iop

Reduction the netted soda is a rock inhibitor i have shown to reduce cellular stiffness it is also nora free in transport inhibitor it faceted at the trabecular and us clear allowed flow the dose once a day day is an effective as effective as the timolol vi d dose and has no contraindication like the timolol the latin of rosetone viewed on enhances the u.s. clairol

Our flow and it is a nitric oxide which dilates the blood vessels and that improves the micro circulation now these both molecule has an additional distinctive feature it can give a neuro protective action so maybe it has a significant role when we are considering the normal tension glaucoma patients so whatever say then done the need for the prolonged treatment

Our chronicity of this disease burden with its cost and tells us to search for the alternative modality of the treatment and we have to breathe the grape between the drug non-compliance and invasive surgery so sustained-release implants in retina as i’ve said have already been causing ripples since its inception so so many roots are shown in this figure so are

We able to find out a route for our glaucoma medication deposition so new delivery systems are in the form of punk talc clock rings to be inserted around the globe that are also available the timolol sustained-release a topical ophthalmic drug delivery system toad is placed under the upper lip which works for three months and latin approach soft contact lenses is

Another way to deliver the drug for a longer period now the latin approach in a large uni lamellar vesicle is derived from the liposomes and it is given as a subject every injection which the effect lasts for 50 days and this provides us a very good external platforms the another is duras at latin prose injections and that also works over a longer period of time

Now what about the internal platform the momemt approach sustained-release implants people are working on and i think the face retrial is been completed to be implanted into the antechamber and it reduces the intraocular pressure by six to eight millimeter of mercury at and vox for these six months similarly trough frost is also to be implanted as an extended

Release biodegradable polymer which reduced 30% reduction of intraocular pressure over eight months period so it’s a drug which is these are the drugs which are going to work for a longer period so that we can avoid the compliance issue the ophthalmic micro pumps are implanted over this clara they are wireless and they are programmable and we can also use it again

It’s a refillable so this it dispenses the nano liter size doses and this implant effectivity lasts up to 12 months now that he could have been a elapsed since the pilocarpine sustained release they prove all your journey has not been completed we are still in a very very slow pace on the completion of this because of the challenges like back packing of the truck

Truck solubility and the time-release versus therapeutic effect so the looking at the alternative strategy to combat the four mansion issues now we are knowing that in india now we have a cyclo g6 is also available and it uses 810 nanometer continuous wave diode laser micro pulse p3 probe and g probe are available for a refractive drachma p3 probe is to be used for

Primary opening of glaucoma patients 200 milli watt of that laser energy is delivered over 100 seconds within 0.5 milliseconds on and 1 point 5 milliseconds off and it delivers 30 per one powering one percent duty cycle basically it is a continuous wave chopped into a short pulse duration li which is less than thermal relaxation time so there is no tissue damage it

Is spared and can be done repeatedly and induces beneficial biological factors it is a non-incisional procedure induces minimal inflammation with excellent safety profile and can be used in our pd procedure and it make it gives us predictable results over a long term period this is how it has been done the clockwise and anti-clockwise cycle is been done and what it

Does it works by widening the extracellular space same as pg analog and the probe is placed on the pass planar region one millimeter away from the limbus and mode fast first in clockwise manner and then backwards in 180 degree and avoid the nine o’clock and 3 o’clock position so now it is time for a minimal innovation everyone is talking bad about the trabeculectomy

Or a filtering surgery so i will be talking little bit on i might yes i will not go into the detail as there is some another speaker who is going to cover on mig s it’s a minimally invasive glaucoma surgery and brings revolutionary approach to the target patients of my tamatar glaucoma and it has a very high safety profile and it can be done ab internal or it can

Be done a beckster no and it preserves the important it issue for the future treatment option if these fields and there are two options external filtration or internal filtration i will not go into the detail of the to save the time and these are the options available and the mig s trebek term is now available in india is fda approved indian government also a nice

Tent or is also available in the western world and now then implanted to come and cyphers micro strength is not been used i will not go into the detail if she is going to cover on the trabectome tablets and the mo’s the trabecular meshwork and unwrapping of the same scannell and it has a tip bend 90 degree to create the triangular protective footplate which acts as

A guide as well as it guides into these lamps canal iceland is the smallest implant known to the body and it has a three ridges which fix it into the slams canal it is appear in coated to promote the self priming and it should be used as a combined surgery with the effects surgery and it gives see the wart is the problem in the open angle glaucoma even the chuck

Struck an allegro tissue is affected so just by putting something there will not work well this ice tent will bypass this and gives us outflow facility and the results are shown in this slide and then strength is a flexible tube and should be implanted certain only last two slides the psifas is super at axillary tube designed to create a control outflow facility

And the hydrous is a long tube and it’s supposed to give a better results so what are the experimental options that we have these days as i said various implants to be put into super axillary region or the nanoparticle or a different delivery systems and injections and the biodegradable implant to be implanted sub conductor le i should not forget our about the

Artificial edges which is very very important in

Transcribed from video
AIOC2020 GP096 T1 Dr Mayuri Khamar New Horizones in Glaucoma Management By AIOS Editor Proceedings 2