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Klinische Monatsblatter Fur... Sep 2020The aim of this paper is to give an overview of different benign and malignant epibulbar tumors. Categories can be made of the age of manifestation (paediatric tumors... (Review)
Review
The aim of this paper is to give an overview of different benign and malignant epibulbar tumors. Categories can be made of the age of manifestation (paediatric tumors versus tumors of adults), the originating cell types (squamous cell tumors, melanocytic tumors, lymphomas or germ cell tumors) or genesis (proliferative, infectious or degenerating tumors). Most epibulbar tumors show lesions on the conjunctiva or the cornea. These can be flesh coloured or pigmented efflorescences with leucoplakias or hyperkeratosis. Especially malignant tumors show atypical growth of blood vessels, are often prominent and can have ulcerations or bleeding. In case of tumor growth, change in pigmentations or atypical bleedings a malign tumor can be suspected. The diagnosis should be confirmed using histopathological evaluation after an incisional or excisional biopsy. Molecular pathologic techniques extend the diagnostic tools and have an implication on the therapy of metastatic tumors. Therapeutic options of the malignant tumors (apart from lymphomas) are chirurgical excision preferably with a no touch technique and afterwards an adjuvant therapy consisting of radiation or cryotherapy. A topical chemotherapy with Mitomycin C, 5-Fluorouracil or Interferon α2b can be effective to reduce persisting precancerosis and reduce recurrences. In case of a suspected malignant tumor it is advisable to refer the patient to an ophthalmo-oncologic center to plan and ensure interdisciplinary therapy.
Topics: Adult; Child; Conjunctiva; Conjunctival Neoplasms; Humans; Melanoma; Mitomycin; Neoplasm Recurrence, Local
PubMed: 32777832
DOI: 10.1055/a-1211-0225 -
International Ophthalmology Aug 2021To compare the efficacy and security of conbercept and ranibizumab combined with trabeculectomy and panretinal photocoagulation for neovascular glaucoma (NVG). (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To compare the efficacy and security of conbercept and ranibizumab combined with trabeculectomy and panretinal photocoagulation for neovascular glaucoma (NVG).
METHODS
One hundred and sixty patients with NVG were randomly divided into a conbercept group comprised of 80 patients and a ranibizumab group comprised of 80 patients. The postoperative and preoperative visual acuities, intraocular pressures frequency of anti-glaucoma medications, and surgical complications were recorded. The expressions of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor (FLT-1), and placenta-like growth factor (PLGF) in the aqueous humor were determined using an enzyme-linked immunosorbent assay. Examining the fundus and obtaining photographs used indirect ophthalmoscopy. Kaplan-Meier and log-rank analyses estimated the success rates.
RESULTS
All patient follow-up periods were at 1 year. The differences observed in IOP and the frequencies of anti-glaucoma medications at various follow-up time points were not statistically significant (all P > 0.05). The differences observed in both the group visual acuities at various follow-up time points were not statistically significant (P > 0.05). Rates of surgery complications were 18.75% and 25.00% in the conbercept group and ranibizumab group, respectively. The expressions of VEGF, FLT-1, and PLGF significantly decreased (all P < 0.05). The recurrence percentages were 30.00% and 36.25% after conbercept and ranibizumab treatment, respectively.
CONCLUSION
The conbercept effects were similar with that of ranibizumab. Intravitreal injection of conbercept was effective for NVG treatment, which provides a new therapeutic drug for NVG treatment.
Topics: Angiogenesis Inhibitors; Glaucoma, Neovascular; Humans; Intraocular Pressure; Intravitreal Injections; Mitomycin; Ranibizumab; Recombinant Fusion Proteins; Trabeculectomy; Treatment Outcome; Vascular Endothelial Growth Factor A
PubMed: 33895882
DOI: 10.1007/s10792-021-01846-6 -
Archivos de La Sociedad Espanola de... Jun 2022To evaluate the spectrum of glaucoma surgery undertaken among members of the Spanish Glaucoma Society (SEG).
PURPOSE
To evaluate the spectrum of glaucoma surgery undertaken among members of the Spanish Glaucoma Society (SEG).
METHODS
A 10 question web-based anonimous survey was mailed through the Annals of the Spanish Glaucoma Society to all its members on January, February and July 2019 to determine their preferred surgical approach.
MAIN OUTCOME MEASURES
Age, type of Glaucoma, surgery undertaken, type of anti-scarring strategy and prothesis introduced for the last 10 surgeries since the survey was received. The surgeon experience was registered in years of practice.
RESULTS
A total of 97 SEG members across the country answered the survey. Sixty-two (63.4%) responders had more than 10 years of experience. Primary open angle glaucoma was the most frequent type of glaucoma (60.6%). The most popular surgery was deep-sclerectomy (37.3%) followed by trabeculectomy (17,6%) and the collagen microshunt (XEN® Allergan Inc., Irvine, CA) (14.1%). Glaucoma drainage device (GDD) was used in 10.5% of the cases. Up to 21.7% of surgeries were reinterventions, where GDD was used in 27.3% and trabeculectomy in 20.3% of the cases. Glaucoma surgery was combined with phacoemulsification in 47.3% of the eyes. Mitomycin C (MMC) was used in 54,8% of the cases, collagen matrix (Ologen®, Aeon Astron Corporation, Taipei, Taiwan) was used alone in 8.2% of the cases and in 13,7% combined with MMC. MMC was used in a soaked sponge in 79% of cases (concentrations of 0.02% in 99% and 0.04% in 1%) and in 21% of cases MMC was injected subconjunctivally (concentrations of 0,01% in 81% and 0.02% in 19%).
CONCLUSIONS
Although the glaucoma surgeon performs a wide range of surgical techniques, deep sclerectomy remains the most widely used surgical technique in Spain. Combined cataract and glaucoma surgery is performed almost in half of the patients and MMC is the most frequently selected antifibrotic agent, alone or combined with collagen matrix. The new minimal invasive surgical techniques represent the 20% of the total.
Topics: Collagen; Glaucoma; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Mitomycin; Spain
PubMed: 35292224
DOI: 10.1016/j.oftale.2022.03.004 -
The Journal of Urology Nov 2023
Topics: Humans; Uncertainty; Urinary Bladder; Mitomycin; Urinary Bladder Neoplasms
PubMed: 37757487
DOI: 10.1097/JU.0000000000003702 -
International Journal of Molecular... Apr 2023Post-surgical scarring is a known cause of trabeculectomy failure. The aim of this study was to investigate the effectiveness of ranibizumab as an adjuvant anti-scarring...
Post-surgical scarring is a known cause of trabeculectomy failure. The aim of this study was to investigate the effectiveness of ranibizumab as an adjuvant anti-scarring agent in experimental trabeculectomy. Forty New Zealand white rabbits were randomised into four eye treatment groups: groups A (control), B (ranibizumab 0.5 mg/mL), C (mitomycin C [MMC] 0.4 mg/mL), and D (ranibizumab 0.5 mg/mL and MMC 0.4 mg/mL). Modified trabeculectomy was performed. Clinical parameters were assessed on post-operative days 1, 2, 3, 7, 14, and 21. Twenty rabbits were euthanised on day 7, and the other twenty were euthanised on day 21. Eye tissue samples were obtained from the rabbits and stained with haematoxylin and eosin (H&E). All treatment groups showed a significant difference in IOP reduction compared with group A ( < 0.05). Groups C and D showed a significant difference in bleb status on days 7 ( = 0.001) and 21 ( = 0.002) relative to group A. H&E staining showed significantly low fibrotic activity ( < 0.001) in group C on both days and inflammatory cell grade in group B on day 7 ( < 0.001). The grade for new vessel formation was significantly low in groups B and D on day 7 ( < 0.001) and in group D on day 21 ( = 0.007). Ranibizumab plays a role in reducing scarring, and a single application of the ranibizumab-MMC combination showed a moderate wound-modulating effect in the early post-operative phase.
Topics: Animals; Rabbits; Cicatrix; Intraocular Pressure; Mitomycin; Ranibizumab; Trabeculectomy
PubMed: 37108535
DOI: 10.3390/ijms24087372 -
International Ophthalmology May 2023The main reasons why Amniotic Membrane (AM) is transplanted in Ophthalmology are: to provide a substrate for cellular growth and to provide tectonic support or as a... (Review)
Review
The main reasons why Amniotic Membrane (AM) is transplanted in Ophthalmology are: to provide a substrate for cellular growth and to provide tectonic support or as a biological bandage and barrier that protects the wound to facilitate an environment for wound healing. The application of AM is well-documented in corneal disorders of various aetiologies [1], however, research within the field has highlighted how it can be used in conjunctival disorders and most recently, in glaucoma and vitreoretinal procedures. This review explores the preservation modalities of AM and summarises the current literature regarding AM transplantation in Glaucoma and Vitreoretinal conditions. AM transplantation in conjunction with trabeculectomy was reported to be used in two different surgical techniques. They differ in relation to the position of the implant: below the scleral flap or over the entire exposed sclera. The results of these studies suggest that AM transplant is a safe procedure that helps in the improvement of the intraocular pressure when associated with trabeculectomies. Moreover, it enhances trabeculectomies success rates when used along with mitomycin C [2]. The use of AM is also described for managing leaking blebs. It is mentioned to be a suitable alternative to conjunctival advancement. Regarding AM transplantation in glaucoma shunt or valve surgeries, the current literature is relatively limited. However, AM has been described as a good tectonic support for shunt procedures [3]. Successful results are described in the literature for surgical treatments using AM plug for vitreoretinal procedures. In particular macular hole closure and rhegmatogenous retinal detachment. In conclusion, AM transplant is a very promising and versatile adjutant therapy. However, further studies are also required for a better understanding and refinement of surgical techniques.
Topics: Humans; Amnion; Glaucoma; Trabeculectomy; Intraocular Pressure; Mitomycin; Sclera
PubMed: 36715957
DOI: 10.1007/s10792-022-02570-5 -
Chest Mar 2021
Topics: Humans; Mitomycin; Neoplasms; Pulmonary Veno-Occlusive Disease
PubMed: 33678275
DOI: 10.1016/j.chest.2020.10.060 -
Der Ophthalmologe : Zeitschrift Der... May 2020Trabeculectomy is the most frequent form of glaucoma surgery. Despite the intraoperative use of antimetabolites, such as mitomycin C (MMC) postoperative scarring...
BACKGROUND
Trabeculectomy is the most frequent form of glaucoma surgery. Despite the intraoperative use of antimetabolites, such as mitomycin C (MMC) postoperative scarring reactions can cause surgical failure. The subconjunctival placement of an Ologen® implant can avoid wound scarring. The additional application of bevacizumab should reduce angiogenesis and thereby scarring reactions and improve the surgical success rate.
METHODS
This was a retrospective single center study of patients with glaucoma after trabeculectomy with MMC. The operation was carried out either without an Ologen® implant (group 1), or with an Ologen® implant as an bevacizumab depot (group 2) or with an Ologen® implant and intrachamber injection of bevacizumab (group 3). The follow-up postoperative observation of intraocular pressure (IOP), complications, subsequent interventions and antiglaucoma treatment was performed for 12 months.
RESULTS
There were no significant differences between the groups with respect to IOP, complications, subsequent interventions and postoperative antiglaucoma treatment. The highest success rate (IOP after 12 months ≤15 mm Hg without treatment) was in group 1 (77.5%), followed by group 2 with 63.6% and group 3 with 57.1% (p = 0.34, χ-test).
CONCLUSION
The highest success rate was achieved in group 1 with MMC but without an Ologen® implant or bevacizumab. In this study the additional use of Ologen® implants and bevacizumab in trabeculectomy was found to be a safe operation method but did not provide any additional benefits.
Topics: Bevacizumab; Collagen; Glycosaminoglycans; Humans; Intraocular Pressure; Mitomycin; Retrospective Studies; Trabeculectomy; Treatment Outcome
PubMed: 31541288
DOI: 10.1007/s00347-019-00972-y -
Biofabrication Oct 2022Non-adherent cells, such as hematopoietic cells and lymphocytes, are important research subjects in medical and biological fields. Therefore, a system that enables the...
Non-adherent cells, such as hematopoietic cells and lymphocytes, are important research subjects in medical and biological fields. Therefore, a system that enables the handling of non-adherent cells in solutions in the same manner as that of adhering cells during medium exchange, exposure to chemicals, washing, and staining in imaging applications would be useful. Here, we report a 'Cell Dome' platform in which non-adherent cells can be enclosed and grown in the cavities of about 1 mm diameter and 270m height. The domes consist of an alginate-based hydrogel shell of 90m thickness. Cell Domes were formed on glass plates by horseradish peroxidase-mediated cross-linking. Human leukaemia cell line K562 cells enclosed in Cell Domes were stable for 29 days with every 2-3 days of medium change. The enclosed cells grew in the cavities and were stained and differentiated with reagents supplied from the surrounding medium. Additionally, K562 cells that filled the cavities (a 3D microenvironment) were more hypoxic and highly resistant to mitomycin C than those cultured in 2D. These findings demonstrate that the 'Cell Dome' may be a promising tool for conveniently culturing and evaluating non-adherent cells.
Topics: Humans; Alginates; Horseradish Peroxidase; Hydrogels; Mitomycin
PubMed: 36170845
DOI: 10.1088/1758-5090/ac95ce -
Translational Vision Science &... Jul 2021To study the in vitro effect of vitamin D3 on the healing response of human Tenon's fibroblasts (HTF) and its possible role in preventing excessive postoperative...
PURPOSE
To study the in vitro effect of vitamin D3 on the healing response of human Tenon's fibroblasts (HTF) and its possible role in preventing excessive postoperative subconjunctival fibrosis.
METHODS
Effect of vitamin D3 on cytotoxicity and cell survival of primary cultured HTF was measured by lactate dehydrogenase and PrestoBlue assays, respectively. Proliferation and migration of vitamin D3-treated HTF (D3-HTF) was determined by CyQUANT proliferation and scratch assay, respectively. The mRNA expression profiles of control-HTF and D3-HTF from six subjects (three with glaucoma and long-term use of topical medications, three with primary pterygium) were assessed by RNA sequencing analyses to identify potential biomarkers for the inhibitory effect on HTF by vitamin D3. Validation of these biomarkers and their potential pathways were performed by quantitative real-time polymerase chain reaction (qRT-PCR) detection.
RESULTS
Pure monolayers of HTF from controls (retinal detachment or squint surgeries), pterygium, and glaucoma subjects were successfully prepared and passaged. Proliferation and migration of pterygium and glaucoma HTF were inhibited by vitamin D3 in a dose-dependent manner, and without cytotoxicity or decrease in cellular viability with concentrations up to 10 µM. The qRT-PCR results were consistent with the transcriptome analyses, vitamin D3 appears to enhance CYP24A1, SHE, KRT16 but suppresses CILP expression in HTF.
CONCLUSIONS
Vitamin D3 can inhibit the in vitro activity of HTF without compromising cellular survivability at concentration up to 10 µM. This has potential clinical application for improving the outcome of pterygium and filtering surgeries.
TRANSLATIONAL RELEVANCE
Vitamin D3 can suppress the in vitro proliferation, migration, and transdifferentiation of human Tenon's fibroblasts, without the cytotoxicity of mitomycin-C, the current standard antifibrotic agent in clinical use.
Topics: Cells, Cultured; Cholecalciferol; Fibroblasts; Humans; Mitomycin; Pterygium
PubMed: 34251424
DOI: 10.1167/tvst.10.8.7