Time Heals All Wounds: Obstacles in Glaucoma Surgery from an Asian Perspective
Glaucoma is the leading cause of irreversible blindness worldwide and is a particular burden on the Asian population. Glaucoma surgeries such as trabeculectomy and glaucoma drainage implants are routinely performed to lower intraocular pressure (IOP) to prevent disease progression. However, scarring...
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doaj-eeffa65dc0a34bd8a9631346eaa974c82020-11-25T03:46:27ZengSAGE PublishingProceedings of Singapore Healthcare2010-10582059-23292015-06-012410.1177/201010581502400206Time Heals All Wounds: Obstacles in Glaucoma Surgery from an Asian PerspectiveZhi Hong Toh0Chrisanda Si Ying Lee1Annabel Chee Yen Chew MBBS, MMed (Ophth)2Shamira Perera MBBS (Hons), B Sc (Hons), FRCOphth3 Yong Loo Lin School of Medicine, National University of Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore Singapore National Eye Centre, Singapore Singapore National Eye Centre, SingaporeGlaucoma is the leading cause of irreversible blindness worldwide and is a particular burden on the Asian population. Glaucoma surgeries such as trabeculectomy and glaucoma drainage implants are routinely performed to lower intraocular pressure (IOP) to prevent disease progression. However, scarring of the filtering bleb limits their long-term success and Asian eyes are more at risk. Although this is so, many existing studies have been done on Caucasian patients, but few have focused solely on Asian patients. Intraoperative anti-metabolites such as Mitomycin-C (MMC) and 5-Fluorouracil (5-FU) are the current mainstay of adjunctive treatments to reduce scarring, and in this review, we evaluate the evolution, benefits and side effects of these agents. Recently, newer methods of wound modulation including anti-vascular endothelial growth factor (VEGF) agents and collagen implants are also being investigated as part of a multi-pronged approach to tackle this problem. Some opportunities exist to limit scarring post-operatively, but it is an ongoing battle.https://doi.org/10.1177/201010581502400206 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zhi Hong Toh Chrisanda Si Ying Lee Annabel Chee Yen Chew MBBS, MMed (Ophth) Shamira Perera MBBS (Hons), B Sc (Hons), FRCOphth |
spellingShingle |
Zhi Hong Toh Chrisanda Si Ying Lee Annabel Chee Yen Chew MBBS, MMed (Ophth) Shamira Perera MBBS (Hons), B Sc (Hons), FRCOphth Time Heals All Wounds: Obstacles in Glaucoma Surgery from an Asian Perspective Proceedings of Singapore Healthcare |
author_facet |
Zhi Hong Toh Chrisanda Si Ying Lee Annabel Chee Yen Chew MBBS, MMed (Ophth) Shamira Perera MBBS (Hons), B Sc (Hons), FRCOphth |
author_sort |
Zhi Hong Toh |
title |
Time Heals All Wounds: Obstacles in Glaucoma Surgery from an Asian Perspective |
title_short |
Time Heals All Wounds: Obstacles in Glaucoma Surgery from an Asian Perspective |
title_full |
Time Heals All Wounds: Obstacles in Glaucoma Surgery from an Asian Perspective |
title_fullStr |
Time Heals All Wounds: Obstacles in Glaucoma Surgery from an Asian Perspective |
title_full_unstemmed |
Time Heals All Wounds: Obstacles in Glaucoma Surgery from an Asian Perspective |
title_sort |
time heals all wounds: obstacles in glaucoma surgery from an asian perspective |
publisher |
SAGE Publishing |
series |
Proceedings of Singapore Healthcare |
issn |
2010-1058 2059-2329 |
publishDate |
2015-06-01 |
description |
Glaucoma is the leading cause of irreversible blindness worldwide and is a particular burden on the Asian population. Glaucoma surgeries such as trabeculectomy and glaucoma drainage implants are routinely performed to lower intraocular pressure (IOP) to prevent disease progression. However, scarring of the filtering bleb limits their long-term success and Asian eyes are more at risk. Although this is so, many existing studies have been done on Caucasian patients, but few have focused solely on Asian patients. Intraoperative anti-metabolites such as Mitomycin-C (MMC) and 5-Fluorouracil (5-FU) are the current mainstay of adjunctive treatments to reduce scarring, and in this review, we evaluate the evolution, benefits and side effects of these agents. Recently, newer methods of wound modulation including anti-vascular endothelial growth factor (VEGF) agents and collagen implants are also being investigated as part of a multi-pronged approach to tackle this problem. Some opportunities exist to limit scarring post-operatively, but it is an ongoing battle. |
url |
https://doi.org/10.1177/201010581502400206 |
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