Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS Deemed to be University, Mumbai, Maharashtra, India.
Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS Deemed to be University, Mumbai, Maharashtra, India.
Eur J Pharm Sci. 2019 May 15;133:1-7. doi: 10.1016/j.ejps.2019.03.007. Epub 2019 Mar 12.
Glaucoma, a gradually progressive class of either chronic eye disease or disorder, occurs due to increasing intra-ocular pressure. To reduce glaucoma, it is essential to stop the progression of IOP in the eye which is achieved by medical treatment, laser treatment and surgery. Profuse conventional drugs and laser surgeries are the primary go-tos for decreasing IOP. However, presently available marketed formulations using anti-glaucoma drugs have issues of either difficulty in crossing the blood retinal barrier (BRB) or lower systemic bioavailability. Hence, the drugs having lower therapeutic index would need to be administered frequently. This repeated systemic administration of high doses of drugs eventually leads to side effects, damage to the eye as well as patient noncompliance. Implants are deemed to be the suitable treatment left when such side effects are to be avoided. An eye implant is one of the choices for restoring the volume of the eye socket following evisceration and enucleation. Implantable drainage devices (IDD) aka glaucoma drainage devices (GDDs) or aqueous shunts are small reconstructive surgery devices, either solid or made of a tube fixed to an endplate. The premonition behind implants is augmenting standard glaucoma surgery which successfully is attained by surgically creating a drainage opening and positioning the device properly on it. All implants are made with an objective of decreasing IOP by enhancing the fluid outflow from the eye. A critical comparison is made among different implants like Molteno: single-plate and Double-plate, Baerveldt drainage implant, Schocket implant, Ex-Press R50 implant, Ahmed glaucoma valve, Krypton implant to the latest one's including iStent, iStent inject, Hydrus, CyPass, XEN and InnFocus.
青光眼是一种慢性眼病或疾病，逐渐进展，由于眼内压升高而发生。为了降低青光眼的眼压，必须停止眼内压的进展，这可以通过药物治疗、激光治疗和手术来实现。大量的传统药物和激光手术是降低眼压的主要方法。然而，目前市场上使用的抗青光眼药物制剂存在要么难以穿过血视网膜屏障（BRB），要么全身生物利用度较低的问题。因此，需要经常使用具有较低治疗指数的药物。这种反复的全身给予高剂量药物最终会导致副作用，对眼睛造成损害以及患者不遵医嘱。当需要避免这些副作用时，植入物被认为是合适的治疗方法。植入物被认为是避免这些副作用时的一种合适的治疗方法。植入物是一种在眼球摘除和眼窝切除后恢复眼窝容积的选择之一。植入式引流装置（ID）又名青光眼引流装置（GDD）或水分流器是一种小型的重建手术装置，有实心的或固定在端板上的管形。植入物的设想是增强标准的青光眼手术，通过手术创造一个引流开口并将装置正确定位在其上，可以成功地实现这一目标。所有的植入物都是为了通过增加眼内液的流出量来降低眼压而设计的。对不同的植入物进行了关键性的比较，如 Molteno：单板式和双板式、Baerveldt 引流植入物、Schocket 植入物、Ex-Press R50 植入物、Ahmed 青光眼阀、Krypton 植入物以及最新的 iStent、iStent inject、Hydrus、CyPass、XEN 和 InnFocus。
