ABSTRACT
AIM: To evaluate the efficacy and safety of a new implant, Suprajet ( VSY Biotechnology, Istanbul, Turkey ) , which is developed for supraciliary and suprachoroidal drainage of aqueous humour. ·METHODS: Five rabbits were included in the study. One Suprajet shunt was implanted in one eye of each rabbit. Implantation was performed by a superior clear corneal incision through the anterior chamber into the suprachoroidal space. Proximal end of the implant was placed in the iris root resting against the scleral spur, distal end was placed in the suprachoroidal space. Rabbits were followed for 4wk. Preoperative and postoperative intraocular pressure ( IOP ) levels were measured with Tonopen AVIA. At last follow-up visit animals were sacrificed and eyes were enucleated. Macroscopic and histopathologic evaluation of the eyes were made. ·RESULTS:Mean preoperative IOP was 18. 6±6. 1 mmHg. Mean postoperative IOP was 8. 4 ± 1. 1 mmHg, at one week. At the 2nd week of the follow-up period one rabbit died. Thereafter, only 4 rabbits were followed. Mean postoperative IOP was 11. 0 ± 2. 8 mmHg at the 2nd week, 9. 50±3. 1 mmHg at the 3rd week and 11. 3 ±3. 3 mmHg at 4th week after the operation. When mean preoperative IOP was compared with the postoperative IOP values, only the IOP at the first week was found as significantly lower ( P=0. 042). There was no statistically significant difference between mean preoperative IOP level and mean IOP level at 2, 3 and 4wk postoperatively (P=0. 66, P=0. 66 and P=0. 102, respectively). As an intraoperative complication, minimal hyphema was noted in three eyes during the surgery. However, the next day hyphema cleared completely. Macroscopic evaluation of the enucleated material showed that in one eye the distal end of the implant was in the vitreous instead of suprachoroidal space, in the other 3 eyes the distal end of the implant was noted in the suprachoroidal space. In all eyes, proximal end of the implant was localized in the anterior chamber angle. Histopathologic evaluation of the enucleated eyes showed deposition of irregular collagen bundles and fibroplasia including numerous fibroblastic and histiocytic cells around the implant. ·CONCLUSION: This preliminary animal study showed that implantation of Suprajet in glaucoma is a promising procedure. Further studies are needed to evaluate its efficacy and safety profile.
ABSTRACT
PURPOSE: To evaluate the effect of panretinal photocoagulation (PRP) on retinal nerve fiber layer thickness (RNFLT) in treatment-naive patients with proliferative diabetic retinopathy (PDR). METHODS: Fifty eight previously untreated eyes of 30 patients with PDR who underwent PRP treatment were enrolled prospectively. All patients had at least six months of follow-up. Detailed ophthalmologic examinations including macular thickness and RNFLT assessments with spectral-domain type optic coherence tomography were performed at baseline as well as the third and sixth posttreatment months. Initial RNFLT and macular thickness of laser administered patients were compared with two separate control groups that were consisted of either nondiabetic patients or diabetics without PDR. RESULTS: The mean age of study patients was 52.4±7.1 years (Range, 32-66 years) and 16 of them (53.3%) were female. At the sixth post-PRP month, visual stabilization or improvement was achieved in 54 eyes (93.1%). No significant difference was demonstrated in initial RNFLT measurements between the study patients and two control groups (p=0.478). Mean RNFLT was measured as 108.5±17.5µm, 115.8±17.6µm, and 103.0±16.4µm at baseline, third and sixth months of the follow-up, respectively. Although RNFLT increase noted at the third post-laser month was statistically significant compared to its baseline values (p<0.001), there was a significant reduction in RNFLT at the sixth post-laser month compared to its baseline values (p<0.001). CONCLUSION: RNFLT increase in the third month of follow-up may be related to ensuing axonal edema. Significant RNLFT decrease at the sixth month of follow-up may be attributed to axonal loss secondary to the laser treatment.
