The way to prevent jet syndrome when conducting linear laser trabeculoplasty

 

(57) Abstract:

The invention relates to medicine and can be used for the prevention of reactive syndrome when conducting linear laser trabeculoplasty. The invention consists in the fact that up to 1 day before performing linear laser trabeculoplasty assign instalatii drug Azopt 1 drop 2 times a day in the operated eye. After performing a linear laser trabeculoplasty for another 3 days. The method allows to increase the effectiveness of prevention jet syndrome when conducting linear laser trabeculoplasty.

The invention relates to medicine, in particular to ophthalmology, and can be used for the prevention of reactive syndrome when conducting linear laser trabeculoplasty (LTP) in primary open-angle glaucoma.

Open angle glaucoma accounts for 70% of primary glaucoma is not only the most frequent but also the most insidious form of this disease, because imperceptibly reduces visual function and often leads to incurable blindness.

Laser traction treatment methods have been widely applied in practice since the late 70's, early 80's and has been widely the ability to influence. In addition, this method of treatment frees patients from permanent instillation and not threatening complications, such as surgical intervention.

However, after the TLP is reactive syndrome. The most serious component of the above-mentioned syndrome is increased intraocular pressure (IOP), which is observed according to various sources 9.2-25.3% of cases. The criterion for the occurrence of reactive hypertension believe the increased IOP by more than 5 mm RT.article At 81.2 per cent of patients IOP increases during the first hours after LTP, 18,2% of patients - four hours after the procedure.

IOP reaches maximum values in two or three hours, then gradually declining. The majority of researchers believe that IOP, reaching a maximum in the first four to eight hours after treatment, gradually decreasing to the end of the first day back to the original level.

For reactive edema syndrome most doctors apply the following groups of drugs: non-steroidal anti-inflammatory drugs, corticosteroids (these drugs mainly affect reactive inflammation and virtually no have an effect on the level of IOP). To prevent elevation of IOP after anhydrase (IR), which play an important role in the secretion of aqueous humor. The medicinal effect of IR is associated with a selective ability to inhibit the activity of carbonic anhydrase - enzyme involved in the hydration and dehydration of carbonic acid.

However, the use of oral IR, such as acetazolamide and methazolamide, accompanied by side effects. Side effects include symptoms of malaise, paresthesias, gastrointestinal disorders (nausea, vomiting and other symptoms), weight loss, depression, anorexia and loss of libido. Also there is information about the appearance of fever, rash (including polymorphic erythema, and syndrome of Stevens-Johnson), crystalluria, blood disorders including thrombocytopenia, hemolytic anemia, leukopenia and agranulocytosis[1, 2, 3].

Currently available for patients two inhibitor of human carbonic anhydrase local application. These drugs have good bioavailability, high selectivity and potent inhibitory activity against carbonic anhydrase isoenzyme II. Having pronounced antihypertensive effect, they are deprived of adverse systemic manifestations. These include the 2% solution dorzolamida hydrochloride (Trusopta) - perevalivaetsya suspension of brinzolamide (Azopt) [1, 3].

The purpose of the invention is to use Azopt as a means of preventing reactive increase in IOP after holding inmates in patients with primary open-angle glaucoma.

the method is as follows.

The drug Azopt is assigned to the patient for 1 day prior to the execution of the TLP 1 drop 2 times a day, after the execution of inmates within 3 days.

The clinical data. This technique was used in 8 patients (10 eyes) with primary open-angle glaucoma. Orcs were performed in the morning, then IOP was measured in a non-contact tonometer hourly for 8 hours None of the patients increase IOP was not.

Sources of information

1. Egorov, A. E. Study of the antihypertensive effect and side effects of the carbonic anhydrase inhibitor dorzolamida hydrochloride. Journal of ophthalmology. - 1996. No. 2. - N-3-4.

2. Epstein, D. L., Grant, M. W.: Carbonic anhydrase inhibitor side effects. Arch. Ophthalmol. 95:1378-1382, 1977.

3. Bayer, A.; Ferrari F.; Maren T. N.; Erb C. Topical carbonic anhydrase inhibitors in the treatment of glaucoma. //J Fr Ophtalmol. 1996; 19(5): p.357-362.

The way to prevent jet syndrome when conducting linear laser trabeculoplasty, including the introduction of drugs, characterized in that 1 sa a day in the operated eye, after performing a linear laser trabeculoplasty for another 3 days.



 

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SUBSTANCE: method involves introducing 0.1-0.3 ml of photosensitizing gel preliminarily activated with laser radiation, after having removed neovascular membrane. The photosensitizing gel is based on a viscoelastic of hyaluronic acid containing khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-2% by mass. The photosensitizing gel is in vitro activated with laser radiation having wavelength of 661-666 nm during 3-10 min with total radiation dose being equal to 100-600 J/cm2. The gel is introduced immediately after being activated. To compress the retina, vitreous cavity is filled with perfluororganic compound or air to be further substituted with silicon oil. The operation is ended with placing sutures on sclerotomy and conjunctiva areas. Compounds like chealon, viscoate or hyatulon are used as viscoelastic based on hyaluronic acid. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity.

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