Glaucoma Battles: Winning the War on the Scar
Glaucoma is one of the leading causes of blindness around the world.
It is caused by a blockage of the fluid drainage system in the eye.
This leads to pressure build-up that threatens to destroy the optic nerve, a very delicate structure of the eye.
Eye doctors wage the battle against glaucoma by using drops and employing a decompressing procedure called trabeculectomy.
Simply put, a tiny hole is made in eyeball to create a channel through which fluid can drain into a reservoir called a bleb.
This bleb is a pocket the surgeon creates with the outermost layer of the eyeball (conjunctiva).
On the surface of the bleb is a network of blood vessels which serve as an alternate drain.
Sounds like an easy mechanical operation? But this is far from the truth.
After trabeculectomy, the surgeon must watch the bleb very closely as it will close if it scars down.
Since the body is naturally bound to heal itself, from a simple cut to a surgical wound, something must be done to avoid this.
A scar evolves from an army of specialized cells called fibroblasts.
As more fibroblasts are recruited, they eventually create a barricade around the site of injury and permanently seal it off with a scar.
Surgeons outwit this natural healing process by employing an arsenal of drugs such as 5-flourouracil (5-FU) and mitomycin (MMC) which stop the onslaught of fibroblasts in the bleb site.
However these drugs (called antimetabolites) are also notorious for thoughtlessly destroying nearby tissue structures of the eye.
They are like blind soldiers in the battlefield aimlessly firing their guns destroying all they encounter.
This destruction of tissue can later result in chronic eye irritation as well as potential infection and loss of vision.
This dilemma has the potential to be solved with a new drug class called Alkylphosphocholines (APCs).
The advantage of APCs lies in their ability to be tissue selective - arresting a growing army of fibroblasts without harming other structures of the eye.
Like a skilled sniper that aims straight at the target without hitting bystanders, APCs may be able to halt the formation of scar tissue while avoiding the vision-threatening side effects of antimetabolites.
Another way to avoid damage to collateral tissue is to use the body's natural drainage ducts (instead of creating a new one).
This is the principle behind Canaloplasty.
This exciting new procedure makes use of a small flexible tube which opens the natural canal of the eye.
Since there is no need for a bleb, it forgoes the need for trabeculectomy and medications like 5-FU and MMC.
It is caused by a blockage of the fluid drainage system in the eye.
This leads to pressure build-up that threatens to destroy the optic nerve, a very delicate structure of the eye.
Eye doctors wage the battle against glaucoma by using drops and employing a decompressing procedure called trabeculectomy.
Simply put, a tiny hole is made in eyeball to create a channel through which fluid can drain into a reservoir called a bleb.
This bleb is a pocket the surgeon creates with the outermost layer of the eyeball (conjunctiva).
On the surface of the bleb is a network of blood vessels which serve as an alternate drain.
Sounds like an easy mechanical operation? But this is far from the truth.
After trabeculectomy, the surgeon must watch the bleb very closely as it will close if it scars down.
Since the body is naturally bound to heal itself, from a simple cut to a surgical wound, something must be done to avoid this.
A scar evolves from an army of specialized cells called fibroblasts.
As more fibroblasts are recruited, they eventually create a barricade around the site of injury and permanently seal it off with a scar.
Surgeons outwit this natural healing process by employing an arsenal of drugs such as 5-flourouracil (5-FU) and mitomycin (MMC) which stop the onslaught of fibroblasts in the bleb site.
However these drugs (called antimetabolites) are also notorious for thoughtlessly destroying nearby tissue structures of the eye.
They are like blind soldiers in the battlefield aimlessly firing their guns destroying all they encounter.
This destruction of tissue can later result in chronic eye irritation as well as potential infection and loss of vision.
This dilemma has the potential to be solved with a new drug class called Alkylphosphocholines (APCs).
The advantage of APCs lies in their ability to be tissue selective - arresting a growing army of fibroblasts without harming other structures of the eye.
Like a skilled sniper that aims straight at the target without hitting bystanders, APCs may be able to halt the formation of scar tissue while avoiding the vision-threatening side effects of antimetabolites.
Another way to avoid damage to collateral tissue is to use the body's natural drainage ducts (instead of creating a new one).
This is the principle behind Canaloplasty.
This exciting new procedure makes use of a small flexible tube which opens the natural canal of the eye.
Since there is no need for a bleb, it forgoes the need for trabeculectomy and medications like 5-FU and MMC.
