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Experience of the combined treatment of atrophy of the optic nerve glaucomatous

Poster Details

First Author: G.Abizgildina RUSSIA

Co Author(s):                  

Abstract Details



Purpose:

studying the influence of xenoplasty with Retinalaminy® upon the visual functions dynamics among the glaucomatosus atrophy of an optic nerve patients.

Setting:

Glaucoma is considered to be one of the first reasons for the development of an irreversible blindness, hypovision and primary disablement . In Russia the morbidity rate reaches 918 cases for each 100 000 of adults with a yearly increase tendency. Development of the glaucomatosus atrophy of an optic nerve (GAON) is degenerated by a degeneracy process that damages the nervous tissue, with marginal cupping of optic disk and retina photosensitivity decrease related to it . The treatment of a glaucomatosus atrophy of an optic nerve is aimed at dysmetabolism correction, haemodynamics improvement and neuroprotection. Effective use of peptide bioregulators within the frame of the optic nerve degenerative changing process has been proved . The use of tissue-specific biomaterials (xenoplast) as a part of glaucoma surgical treatment has been experienced. Neuroprotective action of 'Semaksy' product has been examined. A number of practically used methods and approaches in the glaucomatosus atrophy of an optic nerve treatment gives evidence of the pendency of the problem and requires the further investigations in search of the effective treatment which is pathogenetically based

Methods:

113 Open-Angle Glaucoma patients, aged 50 - 75, with a regulated intraocular pressure have been provided an observed glaucomatosus atrophy of an optic nerve treatment. Visual function state has been estimated according to the results of the common ophthalmological examinations, i.e. before treatment, and 1, 3 and 6 months after. According to the treatment options the patients have been divided into 3 groups. The 1st group have been provided xenoplasty with Retinalaminy® and endonasal electrophoresis with Semaksy (anodic lead 1ma amperage, 15 minutes long); the 2nd group have been provided xenoplasty with Retinalaminy®; and the 3rd group have been provided Retinalaminy® parabulbar injections daily № 10. 'Xenoplasty' operative technique. Conjunctiva and Tenon's coat discission 3- 5 mm long was made in the lower nasal quadrant of the bulbus oculi 6 mm peripheral rim margin, and the tunnel between the sclera and Tenon's coat towards the posterior pole of eyeball was formed. A 5-10 mm recess for the follow-up xenoplast introduction with 1:4th part of the biological product vallecula was plicated. After the 2-hour Retinalaminy® pre- humectation the xenoplast was introduced into the recess with a noose suture put in the conjunctival wound

Results:

Before treatment visual activity of all the patients was equal. In one month treatment period groups I and II showed visual functions 0.1 increases, whereas group III showed a slight decline of the visual function. In three and six months periods a high level of the visual function was recorded only in group I. Glaucomatous atrophy progression criteria have been worked out according to the OCT data. A lower progressive disease in the group with xenoplasty with Retinalaminy® and Semaksy used. The highest progressive disease is presented in group III. After the treatment the average nerve fibre layer thickness with systolic sphygmic dimensions (Av) and minute blood volume (MBV) measurements were correlated in all the groups. Equations of regression between the average nerve fibre layer thickness with Av and MBV measurements were worked out, approximation levels were determined. A significant correlative dependency of the average nerve fibre layer thickness and sphygmometry indices was displayed. Post-treatment correlation coefficient is 0.77 in group I, 0.99 in group II, and 0.84 in group III.

Conclusions:

Using xenoplasty with Retinalaminy® with semaksy as the GAON treatment secures the visual activity increase and the disease stability. 1. Haemodynamics and sphygmometry indices and their correlation give evidence of the influence of the xenoplasty with Retinalaminy® with semaksy upon the dysmetabolism, haemodynamics and neuroprotection (the nerve fibre layer thickness is highly correlated with the systolic sphygmic dimensions and the minute blood volume). 2. The highest curative effect has been reached by combined application of xenoplasty with Retinalaminy® and endonasal electrophoresis with semaksy (p < 0,01), which is indicated by the visual activity increase in 87.7 % cases and haemodynamics measurements improvements of 82 %. The achievements remain for 6 months in group I. In group III the improvements were reached only in 45-50% cases. FINANCIAL INTEREST: NONE

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