GLAUCOMA FILTERING SURGERY: IMPROVED BY DRUG CONJUGATES

FILTERING SURGERY, WHEN SUCCESSFUL, IS AN EFFECTIVE METHOD TO REDUCE INTRAOCULAR PRESSURE AND VISUAL FIELD LOSS IN GLAUCOMA PATIENTS. THE CREATION OF A SURGICAL FILTER IN THESE PATIENTS PROVIDES AN ARTIFICIAL ROUTE FOR AQUEOUS DRAINAGE THAT BYPASS THE TRABECULAR MESHWORK. HOWEVER, THIS PROCEDURE IS CURRENTLY LIMITED TO "END STAGE" GLAUCOMA PATIENTS ONLY, DUE TO THE HIGH FAILURE RATE ASSOCIATED WITH THIS PROCEDURE. THE FAILURE OF THIS PROCEDURE RESULTS FROM THE SCARRING IN THE FILTER WHICH THEN REDUCES AQUEOUS HUMOR OUTFLOW AND RAISES IOP. RECENT CLINICAL STUDIES HAVE DEMONSTRATED THAT SUBCONJUNCTIVAL INJECTION OF ANTIPROLIFERATIVE AGENT. THE USE OF THIS TYPE OF PROTEIN-CONJUGATE DELIVERY SYSTEM SHOULD RESTRICT THE ANTIPROLIFERATIVE AGENT TO THE SURGICAL SITE AS WELL AS INCREASE ITS RESIDENCE TIME. HENCE, THIS PROTEIN-CONJUGATE DELIVERY SYSTEM SHOULD NOT ONLY IMPROVE THE SUCCESS RATE OF FILTERING SURGERIES BUT ALSO REDUCE THE SIDE EFFECTS AND THE NUMBER OF INJECTIONS CURRENTLY ASSOCIATED WITH ANTIPROLIFERATIVE THERAPIES.