Primary Transscleral Diode Laser Cyclophotocoagulation for Management of Glaucoma in Nanophthalmic Eyes.

PURPOSE: The aim of this study was to assess the efficacy and safety of double-row transscleral cyclophotocoagulation in controlling intraocular pressure in patients with secondary angle closure glaucoma due to nanophthalmos, not being controlled by medical therapy. PATIENTS AND METHODS: A prospective case series study that included 13 eyes of 8 patients diagnosed with secondary angle closure glaucoma due to nanophthalmos at the Giza Eye Subspeciality Center, treated by 24 cyclodiode applications in a double-row technique. Success was defined as complete success by control of intraocular pressure <21 mm Hg without medication and qualified success in which control of pressure <21 mm Hg achieved with 1 or 2 medications. RESULTS: The average reduction in intraocular pressure at 3 months was 57.3±20.14% and at 6 months 44.5±32%, with an average eye drop intake of 1.3±0.8 drops. There was a significant reduction of intraocular pressure at 6 months compared with the preprocedure pressure ( P =0.01). Complete success achieved in 3 eyes, pressure controlled without any medication, and qualified success in 9 eyes. CONCLUSION: Transscleral cyclophotocoagulation is a safe and effective primary therapy for managing glaucoma in nanophthalmic eyes.

Nanotechnology - a robust tool for fighting the challenges of drug resistance in non-small cell lung cancer.

Genomic and proteomic mutation analysis is the standard of care for selecting candidates for therapies with tyrosine kinase inhibitors against the human epidermal growth factor receptor (EGFR TKI therapies) and further monitoring cancer treatment efficacy and cancer development. Acquired resistance due to various genetic aberrations is an unavoidable problem during EGFR TKI therapy, leading to the rapid exhaustion of standard molecularly targeted therapeutic options against mutant variants. Attacking multiple molecular targets within one or several signaling pathways by co-delivery of multiple agents is a viable strategy for overcoming and preventing resistance to EGFR TKIs. However, because of the difference in pharmacokinetics among agents, combined therapies may not effectively reach their targets. The obstacles regarding the simultaneous co-delivery of therapeutic agents at the site of action can be overcome using nanomedicine as a platform and nanotools as delivery agents. Precision oncology research to identify targetable biomarkers and optimize tumor homing agents, hand in hand with designing multifunctional and multistage nanocarriers that respond to the inherent heterogeneity of the tumors, may resolve the challenges of inadequate tumor localization, improve intracellular internalization, and bring advantages over conventional nanocarriers.

Agreement profiles for rebound and applanation tonometry in normal and glaucomatous children.

OBJECTIVES: To investigate agreement between intraocular pressure measurements by the rebound tonometer and handheld Perkins applanation tonometer in children with and without primary congenital glaucoma and test agreement with intraocular pressure and age variations. MATERIALS AND METHODS: A prospective non-interventional comparative study done on 223 eyes of 115 children, 161 normal eyes, and 62 eyes with primary congenital glaucoma. Intraocular pressure measurements were obtained in the upright position by rebound tonometer first, followed by installation of topical anesthetic eye drops (benoxinate), then measured by Perkins applanation tonometer. RESULTS: For all eyes, mean difference between Perkins applanation tonometer and rebound tonometer was -0.59 ± 2.59 mmHg, p = 0.001. Regression analysis with (r) = 0.9, (r2) = 0.79, and p < 0.001. In primary congenital glaucoma: there was a mean difference of -.79 ± 2.82 (p = 0.032), a good correlation with (r) = 0.94, (r2) = 0.87%, and 95% level of agreement: -6.34 to +4.76. In normal eyes: mean difference was -.52 ± 2.5 (p = 0.01), correlation: (r) = 0.8, (r2) = 0.64, and p = 0.001. The 95% level of agreement -5.41 and +4.36 mmHg. In intraocular pressure ⩽ 15 mmHg: mean difference -0.89 ± 2.15 mmHg, 95% level of agreement between -5.1 and +3.32 mmHg, p < 0.001. In intraocular pressure >15 mmHg: mean difference was 0.04 ± 3.28 mmHg, 95% level of agreement -6.38 and +6.46 mmHg, p = 0.914. CONCLUSION: There is a good correlation between rebound tonometer and Perkins applanation tonometer in children with and without primary congenital glaucoma; however, rebound tonometer overestimates the intraocular pressure, and in intraocular pressure >15 mmHg there is less agreement between the two devices. Hence, in higher intraocular pressure measurement caution should be taken when interpreting rebound tonometer readings, and a confirmatory measurement using Perkins applanation tonometer is advised.

Pushed monocanalicular intubation versus probing as a primary management for congenital nasolacrimal obstruction.

PURPOSE: Evaluation of efficiency, complications, and advantages of pushed monocanalicular intubation using Masterka(®) tube versus simple probing in patients with congenital nasolacrimal duct obstruction (CNLDO). PATIENTS AND METHODS: This is a case-controlled study that included 60 eyes (of 53 patients); 30 eyes underwent probing and 30 eyes intubation using the Masterka tube as a primary treatment for CNLDO. The children were aged between 6 months and 36 months at the time of surgery, with no previous nasolacrimal surgical procedure, and had one or more of the following clinical signs of nasolacrimal duct obstruction: epiphora, mucous discharge, and/or increased tear lake. RESULTS: We defined success by absence of epiphora, mucous discharge, or increased tear lake 1 month after tube removal. The overall success rate in the probing group was 80%, while it was 83.3% in the intubation group. CONCLUSION: Pushed monocanalicular intubation is an effective method for treatment of CNLDO; it requires only mask inhalation anesthesia and could be considered as an appropriate alternative procedure with imperceptible complications.