Efficacy and safety of deep sclerectomy with uveoscleral implant plus collagen matrix implant overcoming the superficial scleral flap in glaucoma surgery

AIM:To assess the efficacy and safety of non-penetrating deep sclerectomy(NPDS)with uveoscleral implant plus subconjunctival and intrascleral collagen matrix overcoming the superficial scleral flap lips(modified deep sclerectomy technique,DS)and minimal use of mitomycin C in glaucoma surgery.METHODS:A retrospective review of 47 consecutive glaucoma patients who underwent NPDS with DS between January 2017 and May 2018.Best-corrected visual acuity,intraocular pressure(IOP),post-operative need for glaucoma medications,visual field mean deviation(MD),re-interventions,needling revisions and laser goniopuncture were noted.Absolute success was defined as IOP≤18 mm Hg without topical medication.Relative success was defined as the same criteria but with the addition of any antihypertensive medication.IOP over 18 mm Hg on two consecutive followup visits was considered as a failure.RESULTS:Fifty-two eyes of 47 patients were evaluated.Mean preoperative IOP was 25.37±6.47 mm Hg,and decreased to 15.04±4.73 at 12mo and 12.21±4.1 at 24mo(all P<0.0001).Requirement for topical medications dropped from a mean of 3.06±0.25 per patient to 0.51±0.99 and 1.11±1.23 respectively after 12 and 24mo(all P<0.0001).No medications were required in 45.5%of patients after 24mo.Relative and absolute success rate at 24mo were 85.5%±5%and 48.5%±7.4%,respectively.CONCLUSION:DS is a safe and effective nonpenetrating glaucoma surgery variation.It aims to retain the patency of all pathways created for aqueous humor drainage:the intrascleral bleb,the supraciliary space and the open communication between intrascleral and subconjunctival compartments.

Multiscattering-enhanced absorbance to enable the sensitive analysis of extremely diluted biological samples: Determination of oxidative potential in exhaled air

Direct determination of the oxidative potential in exhaled air(OPEA)as a biological indicator of the redox balance status in airways requires an extremely sensitive sensing approach to counterbalance the high dilution of the exhaled air matrix.In opposite to standard colorimetric assays based on Beer-Lambert Law,the use of simple multiscattering-enhanced absorbance(MEA)strategy results in an improved photonic sensing system.Based on this strategy and using the ferrous-xylenol orange assay,analytical performances allowing the detection of 3 pmol of H_(2)O_(2) could be obtained.The comparative analysis of photometric configurations–standard vs MEA–highlights the large absorbance gain obtained for tiny H_(2)O_(2) amounts–from 0 to 30 pmol–whereas similar sensing trends are observed at higher concentration range.The automated introduction of exhaled air sample into the reaction compartment via needle-impinger coupled with the MEA-based photonic cell enables ultrasensitive determination of OPEA in short time(<5 min).A pilot study conducted on healthy subjects(n=22)and chronic obstructive pulmonary disease(COPD)patients(n=23)volunteers shows a significant increase of the OPEA for COPD versus controls and strong negative correlation between OPEA and spirometry parameters(Tiffeneau index:FEV1/FVC)for ex-/non-smokers.Application perspectives to assess inflammatory episodes in obstructive lung diseases are thus made possible using this sensing approach.