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    Creation of a Drug-Coated Glaucoma Drainage Device Using Polymer Technology
    (Amer Medical Assoc, 2009) Şahiner, Nurettin; Kravitz, Daniel J.; Qadir, Rabah; Blake, Diane A.; Haque, Salima; John, Vijay T.; Margo, Curtis E.
    Objective: To create and test a slow-release antifibrotic drug-coated glaucoma drainage device using in vitro and in vivo experiments. Methods: A slow-release device incorporating mitomycin C in poly(2-hydroxyethyl methacrylate) disks was developed using redox-polymerization techniques. A standardized preparation of this drug delivery device was attached to the Ahmed glaucoma valve (model FP7; New World Medical, Inc, Rancho Cucamonga, California). Semicircular disks (5 x 6 mm) of P(HEMA)-mitomycin C containing varying concentrations of mitomycin C per gram dry weight of the gel were attached to the lower half of an Ahmed glaucoma valve plate. Water was pumped through the modified Ahmed glaucoma valve at a rate comparable to that of aqueous humor outflow, and mitomycin C release was measured. Modified and unmodified Ahmed glaucoma valves were implanted in a rabbit model, and drug release and fibrosis were assessed after 3 months. Results: The P(HEMA)-mitomycin C device released mitomycin C in vitro over 1 to 2 weeks. Studies in rabbits revealed that mitomycin C was released from the disks during the 3-month implantation. Histologic analysis demonstrated a significant reduction in inflammatory reaction and fibrosis in the resulting blebs. Conclusion: Our slow-release drug-coated glaucoma drainage device decreased fibrosis and inflammation in the resulting bleb in a rabbit model. Clinical Relevance: This device could reduce the failure rate of glaucoma drainage devices.