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The preservative effectiveness to the corneal epithelial cell toxicity is that you can see the consideration of the bak which is not higher than 20 microgram going to cost less corneal epithelial cell toxicity but if the big headed is higher than 15 milligram going to cost the corneal epithelial cells toxicity more and of course it going to give you the high

Preservative effectiveness so we want the one that have still have efficacy of the preservative and also have the least corneal epithelial toxicity of the self so it seems like the concentration of the of the 10 micro gram of the bak may be the best why don’t we choose the last like three microgram because three microgram of the bak still not control the e.coli

Infection rates so that may cause the intron microbial efficacy off the medication worse that’s why we have to use the bak date is higher than 50 micro gram so this one that we are using for the new product in the traffic 10 or the tougher cross is 210 my program of the bak so it seems to have still have antimicrobial if you casey and still have maintained the effects

Of the preservative so this one is the effect of the top across on the human culture corneal epithelial cells of course without a bak it’s going to be the least of the toxicity but with the concentration of the breakages only 10 micro gram it seems like the efficacy the effect of that medication on the human culture culture corneal epithelial cells is about the

Same as without preservative so the least is the best but we need the middle right we need the preservative that is still effective for maintain the function of the medication long term used and also increased the after the aqueous info the two lovering the intro for pressure this one is to prove us is there any epithelial cells the konnyaku cells damaged or not

By using the trans capital electric resistance in which in vivo this one compared the bak concentration which less than 20 micro gram of bak going to have less or no excerpt cell toxicity but if the bak consideration more than 50 micro gram it will be significantly more toxic and also this is the change of the of the concentration of the bak and changing of the

Cornea toxicity by the by the test that we use and it confirmed that less than 20 micro gram of the bak still preserved the function of the cells also you lots of you also me myself at the first time that i see that this medication has very least bak concentration i would like to see as well that the talks are on the efficacy of the interclub person luring efficacy

Of this medication still the same as the others prostaglandin so this one is the paper has been made in japan in 2011 to prove that this medication has alcala hypertensive efficacy and safety in normal tension glaucoma by using normal tension call commissioner on 44 patients and evaluate the intro qua pressure lowering at the kc and this one has the prove us that in

This study it shows the strong alcala hypotensive effects and safety for at least six months of the updated trial how about the intraocular pressure lowering in oklahoma tension and npo ag so this one also they try as a multiple centers use around fifty four weeks or a year by using patients in pio 80 and gg alkali / tension exfoliation glaucoma and again pittman

Treat glaucoma in around 350 patients by using this traffic cause once delhi and the eye pressure lowering is quite effective the best best i mean elf in charcoal pressure is not that much as you can see so the intro para sure six millimeter mercury is quite a happy number to me though so what am i doing in my practice because when i first used this medication

If you daba bout the intro pressure lowering of the kc you can try this on the patient that use just only one medication first and this this is the patient the female patient 57 years old she’s an indian indian lady who first diagnosis of a ocular attention in 2005 and she’s been taking the fixed combination brimonidine similar for twice a day and once she’s been

Meeting me she met me in glaucoma clinic in 2008 her her internal pressure is around 24 in the right and 29 it left and because of her compliance that has been used his medication twice a day is impossible so i changed her to latin across once a day the intraoperative ii okay is 22 and 23 and he’s been she’s been using this medication from four years at least the

Hibernia irritation with multiple drugs start happens to her once the hypermile start i tried to keep switching her from latin across to travel cross two lots of medication and even though to and finally come back to the brimonidine p but she’s still unhappy and cannot tolerate to any medication this is her visual fantastic autograph which is still quite good and

Also the visual function is still intact in both eyes also the regular de written off a billiard thickness is still quite okay so what i am doing is i try to stop every medication at that time because she’s very suffer through lots of education and i close monitor finally who i pressure is rising 2 30 to 31 which is too much for me so i do start this medication

Which is the new medication at that moment the eye pressure is come down to 23 to 24 the eye pressure lower around 25 percent and finally she’s still taking this medication for at least a year or a year and a half and there’s no hyperemia or any irritation at all i have to say that this medication answer me in lots of questions especially in ocular surface problem

But around the intraoperative the casey i have to said it depends on each patient individually so we could not tell any patients appropriate to any medication but f if you have to use this medication for a long period of time you know that this patient is quite i have to say old because this ocular surface is a problem of yours even before you start the integral

Communication so the one did you choose is probably the most aqua love friendly medication which right now we believe that the least bak concentration is probably the best however if you start this medication you have to also close monitor about the intraocular pressure lowering efficacy of this patient as well because if your patient not response to price opened in

Or view patients still have any allergy to the bak this medication is probably not the appropriate one but i believe that in most patient of yours they will happy with this medication if the eye pressure could not be controlled you can check you can try switch to the same group i mean in the prosecco and in themselves in the other other brand of the prostaglandin

Because there’s something in prostaglandin that is different in each one and still can give your patients that is fine with the once daily medication if you try this one it will be the least bak it will be the least concentration of major ingredients it almost bak free but of course it still have bak so you have to use it with the caution as well but i do believe

That many of your patients will have been with this medication so let’s try and let’s see in the future for the long-term research is there any any new concern or any benefit from this medication such as increasing intraocular pressure blood flow to the optic nerve or increasing the neuroprotective effects which is right now we still need that in the market but

Still no medication right now so let’s try and let’s see in the future what is going on thank you thank you

Transcribed from video
th2 By Zhuge Liang