0
Viewpoint | Translational Science With Clinical Promise

Combination Therapy to Reduce Conjunctival Scarring After Glaucoma Surgery

Marco A. Zarbin, MD, PhD1
[+] Author Affiliations
1New Jersey Medical School, Institute of Ophthalmology and Visual Science, Newark
JAMA Ophthalmol. 2013;131(9):1123. doi:10.1001/jamaophthalmol.2013.5575.
Text Size: A A A
Published online

Extract

Glaucoma is the second leading cause of blindness worldwide.1 Although the mainstay of glaucoma therapy is medical management,2 surgery is an important yet complex component of treatment for many patients. While filtration surgery often achieves intraocular pressures lower than those achieved with medicine or laser surgery, excessive bleb scarring is a common cause of surgical failure. The scarring involves fibroblasts of the fascia bulbi (also known as the Tenon capsule, after the French surgeon and pathologist Jacques-Renee Tenon). Managing the wound-healing response requires achieving a precarious balance between inhibiting scarring and permitting scarring. With too little scarring, there is a higher likelihood of overfiltration, hypotony, and choroidal detachment. Mitomycin C (MMC) promotes prolonged filtration by inducing apoptosis of human Tenon fibroblasts. However, MMC can be associated with complications such as hypotony maculopathy3 and bleb leaks.4 Thus, additional improvements in the control of wound healing would probably make incisional glaucoma surgery safer and more effective.5

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();