CLINICAL STUDIES
Purpose: a comparative study of the efficacy and safety of the Latanoprost-Optic drug and the original latanoprost drug administered to previously untreated patients with primary open-angle glaucoma (POAG). Material and methods. A double-blind, randomized, parallel-group study involved 60 patients (70 eyes) with newly diagnosed POAG, who were randomly divided into 2 groups of equal size. The patients of the main group (34 eyes) received Latanoprost-Optic, whilst the control group received the original preparation of latanoprost, 1 instillation in the evening. The reference points were the values of intraocular pressure, visual acuity, perimetric indices (standard deviation, standard deviation pattern), the average thickness of the retinal nerve fiber layer, the minimum width of the neuroretinal girdle, the thickness of the retinal nerve fiber layer in the macula, the thickness of the ganglion cell layer in the macula, the thickness of the inner plexiform layer, and the safety (adverse events). The observation period was 12 weeks. Results. After 2 weeks, both groups showed a statistically significant decrease in intraocular pressure, which remained stable after 6 and 12 weeks. The average decrease in intraocular pressure of those receiving Latanoprost-Optic was 30% and at no control point a statistically significant difference from the original drug was revealed. A positive dynamic of visual acuity, static perimetry indices and optical coherence tomography was registered, showing n significant intergroup differences. This may indicate that the drugs have an indirect neuroprotective effect. The adverse events included discomfort and redness of the bulbar conjunctiva, which were recorded in 7 out of 30 patients in the study group and in 6 out of 30 patients in the control group. All of them were mild and completely reversible. No serious or systemic adverse events were reported. Conclusion. Latanoprost-Optic has an efficacy comparable to that of the original latanoprost drug and has a comparable favorable safety profile.
Purpose: to study the effectiveness of the use of thrombofibrin clot of platelet-rich plasma (PRP) in patients with corneal ulcers. Material and methods. A clinical study, conducted by the Department of Traumatology and Reconstructive Surgery of Helmholtz National Medical Research Center of Eye Diseases, involved 20 patients, aged from 22 to 82, with corneal ulcers of inflammatory and burn genesis more than 100 microns deep. All patients got coated with a thrombofibrin PRP clot from autologous blood. Prior to the study, all patients received standard treatment for 2 weeks to 3 months, including multiple amniotic membrane coating, with no effect. The thrombofibrin clot was produced by the Scientific Department of Biotechnology and Transfusiology of the N.V. Sklifosovsky Research Institute for Emergency Medicine. The ready clot was placed on the surface of the cornea and covered with an amniotic membrane. The membrane was fixed to the episclera along the border of the limb with a circular suture, whereupon autologous serum was injected along the limb in 4 quadrants, to be followed by temporary lateral blepharography. Results. On the 2nd day following the procedure, the patients noted a decrease in lacrimation and pain in the operated eye. As shown by optical coherence tomography, the average depth of the corneal ulcer at the beginning of the study in all patients was 129 ± 28.5 microns. On the 5th day, the depth lowered to an average of 71 ± 32.6 microns, and on the 10th day, to 23.3 ± 15.1 microns. In 7 patients (35%), complete healing of the defect was observed on the 15th day, while in 9 patients (45%) it was stated between the 16th and the 20th day. Thus, the average time of healing of the ulcer with complete epithelization occurred was 15 days. In four patients with the consequences of severe burns (20%), the ulcer did not heal due to extensive damage to the limbal zone. Conclusion. The use of a thrombofibrin PRP clot in combination with amniotic membrane transplantation allows achieving a stable and fairly rapid healing of corneal ulcers of various origins. However, this method is ineffective in patients with limbal cell insufficiency, severe burns and extensive damage to the limbal zone. In such cases, it is advisable to use more radical surgical methods, such as buccal or limbal cell transplantation, or allolimbal transplantation.
FOR OPHTHALMOLOGY PRACTITIONERS
Purpose: to evaluate the effectiveness of platelet-rich plasma lysate (PRP) in the treatment of patients with post-traumatic eyelid scarring by clinical examples. Material and methods. Patients with post-traumatic scarring changes in eyelid tissues causing a damage in the functional and cosmetic state of the auxiliary apparatus of the eye were treated in the Department of Plastic Surgery and Eye Prosthetics at the Helmholtz National Medical Research Center of Eye Diseases. Two of the patients, who had been traumatized shortly before the examination and one patient who had rejected surgery were offered treatment by PRP lysate manufactured at the Sklifosovsky Medical Research Institute of Emergency Medicine. After local infiltration anesthesia, each patient received a single injection of PRP lysate (2 ml) into the scar tissue. The result was evaluated at a follow-up that took place 3 months after the injection. Results. The clinical picture of the three patients showed a pronounced positive dynamic of the functional and cosmetic state of the auxiliary eye apparatus, which made the patients reject subsequent (additional) surgical treatment. Conclusion. An improvement tissue repair and regeneration processes after PRP lysate injection allows us to assess this method as an applicable alternative of reconstructive operations in certain cases.
ISSN 2587-5760 (Online)