ABSTRACT
PURPOSE: To investigate the role of early and prolonged administration of aqueous suppressants in reduction of hyperencapsulation and intraocular pressure (IOP) control after paediatric Ahmed glaucoma valve (AGV) implantation. METHODS: A prospective randomized interventional study recruited children who had AGV implantation for paediatric glaucoma. All patients received postoperative Timolol 0.5% for either 12 months (Group A) or 3 months (Group B). Additional IOP-reducing medications were added if IOP exceeded 21 mmHg or hyperencapsulation developed in either group. Primary outcome measures were rate of hyperencapsulation and reduction of IOP. RESULTS: Eighty sex children completed the 12-month follow-up visits. Baseline IOP was significantly reduced from 31.95 ± 9.1 to 16.94 ± 3.4 mmHg at 12 months in Group A and from 32.7 ± 7.4 to 19.85 ± 6.9 mmHg at 12 months in Group B. IOP was significantly lower in Group A than B at 6-, 9- and 12-month follow-up visits. In the first 4 months, the hyperencapsulation rate was similar in both Group A (six eyes, 13.3%) and Group B (seven eyes, 17.1%). However, the hyperencapsulation rate was significantly lower in Group A than B at both 6 months (22.5% versus 36.6%) and 12 months (31.1% versus 46.3%). Anti-glaucoma medications were significantly lower in Group A than B at both 6 months (1.3 versus 3.2 drugs) and 12 months (1.5 versus 3.6 drugs). CONCLUSION: Early and prolonged use of aqueous suppressants significantly reduced the rate of hyperencapsulation and provided better IOP control after paediatric AGV implantation.
Subject(s)
Glaucoma Drainage Implants , Glaucoma/therapy , Intraocular Pressure/physiology , Postoperative Complications/prevention & control , Timolol/administration & dosage , Visual Acuity , Weaning , Adolescent , Antihypertensive Agents/administration & dosage , Child , Child, Preschool , Female , Follow-Up Studies , Glaucoma/physiopathology , Humans , Infant , Male , Ophthalmic Solutions , Postoperative Period , Prospective Studies , Time Factors , Treatment OutcomeABSTRACT
A cyclohexanecarboxamide derivative, N-phenyl-N-[1-(piperidine-1-carbonyl)cyclohexyl] benzamide (MNRC-5), was evaluated for its inhibitory effects on Schistosoma mansoni cercarial serine protease activity and cercarial penetration. MNRC-5 exerted an inhibitory effect on S. mansoni cercarial serine protease at serial concentrations of the specific chromogenic substrate Boc-Val-Leu-Gly-Arg-PNA for such enzyme family and the inhibitory coefficient (Ki) value was deduced. Moreover, topical treatment of mice tails with the most potent inhibitory concentration of MNRC-5 formulated in jojoba oil successfully blocked cercarial penetration as demonstrated by a significant reduction (75%; p < 0.05) in the recovered S. mansoni worms from treated mice in comparison to control ones whose tails were painted with jojoba oil base containing no MNRC-5. In addition, the IgM and IgG reactivities to crude S. mansoni cercarial, worm and egg antigens were generally lower in sera from treated infected mice than untreated infected mice. In conclusion, we report on a new serine protease inhibitor capable for blocking penetration of host skin by S. mansoni cercariae as measured by lowering worm burden and decrease in the levels of both IgM and IgG towards different bilharzial antigens upon topical treatment.
