Antiglaucoma Drugs Research Articles

Evaluating the greenness, blueness, and whiteness of spectroscopic and UPLC techniques for the simultaneous measurement of anti-glaucoma drugs and the preservation agent

The pursuit of sustainable solutions is increasingly crucial in contemporary times. We propose inventive research that fulfills the criteria of whiteness and greenness in analytical chemistry. The endeavor aims to advance environmentally conscious techniques for the simultaneous detection of timolol maleate (TIM), dorzolamide HCl (DOR), and benzalkonium Cl (BNZ). The first method employed a sustainable mobile phase consisting of 0.02 M phosphate buffer: ethanol (68:32, v/v), and a flow rate of 0.6 mL/min with retention times 1.274, 1.798, and 2.483 min for DOR, TIM, and BNZ, respectively, with a UV detector at 210 nm. This methodology was easy, fast, and accurate. The approach showed low processing times, peak symmetry, and satisfactory resolution, with correlation values of 0.999. The linearity was between 0.001–0.064, 0.001–0.060 µg mL-1, and 0.001–0.050 µg mL-1for DOR, TIM, and BNZ, respectively. Furthermore, employing water as the solvent, complementary spectrophotometric methods such as Mean Centering of Ratio Spectra (MCR) and Successive Derivative Ratio Spectra (SRDS) were investigated as economical and environmentally friendly substitutes. All procedures demonstrated good linearity (r² > 0.9990), acceptable accuracy, and precision (RSD ≤ 2 %). Furthermore, by proving the superiority of the current work over previously published methods regarding sustainability, analytical performance, economics, and practicality, the real-world implementation of four greenness and whiteness algorithms boosts the approval and overall sustainable development of the proposed methods. The suggested techniques offer low-cost, environmentally friendly substitutes for traditional methods, advancing the field of analytical chemistry towards more sustainable practices and fostering a less destructive future for quality control.

Efficacy and safety of the new generation of excimer laser trabeculotomy in aheterogeneous patient population-1-year follow-up

Microinvasive procedures have become established in glaucoma surgery and are preferred for patients with target pressure values that are not too low. Excimer laser trabeculotomy (ELT) represents such aminimally invasive approach and can easily be combined with cataract surgery. Over 12months the reduction in intraocular pressure (IOP), the number of antiglaucoma drugs and the incidence of adverse events were evaluated using the new EliosTM method (Elios Vision GmbH, Germering, Germany) for real-life data from aheterogeneous patient population undergoing ELT in combination with cataract surgery (phaco-ELT). In this study 20eyes of 13patients who underwent phaco-ELT were retrospectively analyzed. After standard phacoemulsification with posterior chamber lens implantation, 10microchannels were created using the excimer laser. The patients were followed for 12months and the intraocular pressure (IOP), number of antiglaucoma drugs and the occurrence of adverse events were analyzed. The average age was 65years. The preoperative IOP was 17.5(± 5.3) mm Hg. The mean IOP reduction was 4.8 mm Hg (27.4%, p < 0.001) on the first postoperative day, 3.2 mm Hg (18.3%, p = 0.22) after 6months and 2.5 mm Hg (14.3%, p = 0.14) at 12months. The number of antiglaucoma drugs decreased from an average of3.2 (± 1.3) preoperatively to0.5 (± 0.9) on day1 (p < 0.001), 1.9(± 1.2) after 6months (p = 0.008) and 2.2(± 1.3) after 12months (p = 0.013). In our cohort ELT in combination with cataract surgery is asafe minimally invasive procedure leading to an IOP reduction of 14.3% and areduction of pressure-lowering medication by1 active ingredient in patients with low initial pressure at 1‑year follow-up. As no implant is used in ELT and the conjunctiva remains untouched, subsequent procedures, including bleb-related surgery, are not negatively affected.

Multi- and poly-pharmacology of carbonic anhydrase inhibitors.

Eight genetically distinct families of the enzyme carbonic anhydrase (CA, EC 4.2.1.1) were described in organisms allover the phylogenetic tree. They catalyze the hydration of CO2 to bicarbonate and protons, and are involved in pH regulation, chemosensing and metabolism. The 15 α-CA isoforms present in humans are pharmacological drug targets known for decades, their inhibitors being used as diuretics, antiglaucoma, antiepileptic or antiobesity drugs, as well as for the management of acute mountain sickness, idiopathic intracranial hypertension and recently, as antitumor theragnostic agents. Other potential applications include the use of CA inhibitors (CAIs) in inflammatory conditions, cerebral ischemia, neuropathic pain, or for Alzheimer's/Parkinson's disease management. CAs from pathogenic bacteria, fungi, protozoans and nematodes started to be considered as drug targets in recent years, with notable advances registered ultimately. CAIs have a complex multipharmacology probably unique to this enzyme, which has been exploited intensely but may lead to other relevant applications in the future, due to the emergence of drug design approaches which afforded highly isoform-selective compounds for most α-CAs known to date. They belong to a multitude of chemical classes (sulfonamides and isosteres, (iso)coumarins and related compounds, mono- and dithiocarbamates, selenols, ninhydrines, boronic acids, benzoxaboroles, etc). The polypharmacology of CAIs will also be discussed since drugs originally discovered for the treatment of non-CA related conditions (topiramate, zonisamide, celecoxib, pazopanib, thiazide and high-ceiling diuretics) show efective inhibition against many CAs, which led to their repurposing for diverse pharmacological applications. Significance Statement Carbonic anhydrase inhibitors have multiple pharmacologic applications as diuretics, antiglaucoma, antiepileptic, antiobesity, anti-acute mountain sickness, anti-idiopathic intracranial hypertension and as antitumor drugs. Their use in inflammatory conditions, cerebral ischemia, neuropathic pain, or neurodegenerations started to be investigated recently. Parasite carbonic anhydrases are also drug targets for antiinfectives with novel mechanisms of action which can by pass drug resistance to commonly used such agents. Drugs discovered for the management of other conditions that effectively inhibit these enzymes exert interesting polypharmacologic effects.

Ocular pharmacokinetics of acetazolamide from intravitreal implants by high-performance liquid chromatography coupled to tandem mass spectrometry

Glaucoma, a leading cause of irreversible blindness, affects about 70 million people globally. Its treatment focuses on reducing intraocular pressure. Acetazolamide, a potent anti-glaucoma drug, is currently used only systemically due to low solubility and permeation, which cause severe side effects. Developing topical medications with acetazolamide requires robust analytical methods for its detection in biological samples. In this context, this study aimed to develop a method to quantify acetazolamide in rabbit vitreous humor samples. The method involved a simple, fast, inexpensive, and environmentally friendly protein precipitation step for sample preparation, needing just 50 μL of sample and 200 μL of organic solvent, with adequate recovery. This was combined with high-performance liquid chromatography coupled to tandem mass spectrometry, enabling highly sensitive (LOQ of 5 ng/mL) quantification within only 5 min. The method proved to be selective, precise, and accurate, with well-fitted analytical curves, with no carryover, and no matrix effect impacting reliability. The method was successfully applied to analyze vitreous humor samples from rabbits in pharmacokinetic studies, monitoring drug release from intravitreal implants. Results showed a controlled release profile, with a maximum drug concentration (Cmax) of 426.01 ± 64.57 ng/mL, time to reach Cmax (Tmax) of 28 days, and area under the curve (AUC0–42 and AUC0-∞) of 7722.66 ± 1125.96 ng days/mL and 8998.11 ± 1311.92 ng days/mL, respectively. The device demonstrated significantly slower elimination, ensuring therapeutic levels for an extended period when compared to intravitreal injection.

To Assess and Compare the Effect of Combination of Anti-Glaucoma Drug on Corneal Endothelium in Primary Glaucoma Patients with Age Matched Healthy Control

To Assess and Compare the Effect of Combination of Anti-Glaucoma Drug on Corneal Endothelium in Primary Glaucoma Patients with Age Matched Healthy Control

Efficacy of gonioscopy-assisted transluminal trabeculotomy and trabeculectomy in patients with primary open-angle glaucoma and pseudoexfoliative glaucoma: A single surgeon's experience.

To compare the intraocular pressure (IOP)-lowering efficiency of gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy (TRAB) with mitomycin C in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG). In this retrospective comparative study, consecutive patients with POAG or PEXG who underwent GATT or TRAB by a single surgeon and with a follow-up period of at least 1 year were included. Surgical success rates, change in best-corrected visual acuity, IOP, the need for antiglaucoma medication, surgical complications, and the need for additional glaucoma surgery were compared. Surgical success was defined as an IOP reduction of ≥30% or an IOP of ≤18 mmHg. Complete success was defined as without medication. Qualified success was defined as with or without topical medication. The mean baseline IOP was 27.4 ± 8.3 and 24.6 ± 7.6 mmHg (P = 0.13) with the mean number of medications being 3.7 ± 1.0 and 3.7 ± 1.1 (P = 0.98) in TRAB and GATT, respectively. At 12 months, the mean IOP was 15.3 ± 3.5 and 12.5 ± 4.6 mmHg (P = 0.24) with the mean number of medications being 0.9 ± 1.2 and 0.8 ± 1.4 (P = 0.76) after GATT and TRAB, respectively. IOP was lowered from baseline by 52.7% ± 17.5% after TRAB and 45.7% ±18.6% after GATT (P = 0.12). There was no decrease in best-corrected visual acuity in either group. The qualified surgical success rate was 94.4% in the GATT group and 94.9% in the TRAB group (P = 0.75). Percentage of complete success was 64.1% and 52.8% (P = 0.22) after TRAB and GATT, respectively. In patients with POAG and PEXG, GATT was as effective and safe as TRAB in lowering IOP and reducing the number of antiglaucomatous drugs.

The Achievement of IOP Target Among a Sample of Iraqi Patients with Glaucoma: A Retrospective Study.

Glaucoma is a chronic progressive eye disorder. It is the primary cause of blindness. To prevent glaucomatous damage and blindness, the intra-ocular pressure (IOP) must be lowered to certain levels, this level is known as "IOP" target. Many studies conducted in developed countries have found that the majority of glaucoma patients failed to reach their target IOP. This study aimed to assess the achievement of IOP target among Iraqi patients with glaucoma and to determine the factors affecting it. A single-center retrospective cohort study was conducted by inspecting the records of all patients with confirmed cases of glaucoma who were admitted to the Ibn-Al-Haitham Hospital outpatient unit from January 2020 to December 2022. To be included in the study, the patient must be newly diagnosed with glaucoma. In addition, full information on the patient's demographics, medical therapy used, and IOP at baseline and after 1 month of treatment must be available in the patient's case sheet. After considering the study inclusion criteria, the records of 760 patients were excluded, and only 100 patients were eligible. The included patients were mostly males, with an average age of 57.86 years. A 70% of the patients had elevated IOP in both eyes. Most patients (38%) were treated with two anti-glaucoma drugs. Only 35% of the patients achieved their targeted IOP. Regarding the factors influencing the achievement of the IOP target, all demographic data (age and gender) had a non-significant effect, while the number of prescribed drugs affected the ability of the patient to reach the IOP target. Most of Iraqi glaucomatous patients do not achieve their IOP target. The number of prescribed eye drops can significantly affect the ability of glaucoma patients to reach their targeted IOP.

Consistent Intraocular Pressure Reduction by Solid Drug Nanoparticles in Fixed Combinations for Glaucoma Therapy.

Efficient topical drug delivery remains a significant challenge in glaucoma management. Although nanoparticle formulations offer considerable promise, their complex preparation processes, co-delivery issues, and batch consistency have hindered their potential. A scalable fabrication strategy is developed here for preparing solid drug nanoparticles (SDNs) with enhanced drug delivery efficiency. Utilizing hydrophobic antiglaucoma drugs brimonidine (BM) and betaxolol (BX), uniform fixed combination BM/BX SDNs are fabricated through a continuous process, improving batch-to-batch consistency for combined glaucoma treatment. With trehalose being used as a lyoprotectant, BM/BX SDNs can be stored as dry powder and easily reconstituted in phosphate buffered saline. Importantly, reconstituted BM/BX SDNs form clear, homogenous solutions, and exhibit negligible cytotoxicity and irritation, making them well-suited for topical administration as eyedrops. Ex vivo and in vivo studies demonstrated that topically applied BM/BX SDNs permeate through the cornea significantly (about two fold to three fold) compared to their hydrophilic counterparts, i.e., brimonidine tartrate, and betaxolol hydrogen chloride. Notably, BM/BX SDNs displayed consistent intraocular pressure lowering effects in vivo in both normotensive rats and glaucoma mice. Collectively, this study demonstrates the potential of the scalable fabrication strategy and the resultant BM/BX SDNs for improving glaucoma management through eyedrops.

Corneal Transplantation in a Patient With Nonperforating Ocular Contusion Caused by a High-Pressure Washer: A Case Report

Purpose: This report details a rare case of a high-pressure washer injury that caused ocular contusion, vitreous hemorrhage, and irreversible corneal edema without perforation necessitating corneal transplantation. Methods: The medical chart of a patient with a high-pressure washer injury at Miyata Eye Hospital (Miyazaki, Japan) was retrospectively reviewed. Results: A 57-year-old man presented to our hospital with a contusion in the left eye caused by a high-pressure washer 1 day prior to the visit. The visual acuity in the left eye was hand motion. Slit-lamp examination of the left eye revealed the presence of corneal epithelial defects, conjunctival lacerations, hyphema, and lacerated iris. Mild clouding of the lens was observed in the anterior chambers, suggestive of cataract. Anterior segment optical coherence tomography revealed the presence of blood in the anterior chamber and a thickened and edematous cornea. Ultrasound examination revealed the presence of vitreous hemorrhage. Therefore, vitreous surgery and traumatic cataract removal were performed under general anesthesia. Postoperatively, the corneal edema and marked opacity persisted, accompanied by glaucoma, and the visual acuity was measured at 0.01. Penetrating keratoplasty was performed 1 year and 2 months after the injury, and scleral fixation of the intraocular lens was performed under local anesthesia 2 years after the injury. The final visual acuity was 0.1 under rigid gas-permeable contact lens usage 3.5 years after sustaining the injury, and the patient required anti-glaucoma drugs. Conclusions: Our patient presented with ocular trauma caused by a high-pressure washer. Corneal transplantation was required although no ocular lacerations were detected. Sufficient instructions must be provided on the usage of heavy machinery to develop a safe working environment.

Comparative analysis of the effect of drugs lowering intraocular pressure on a primary culture of human corneal epithelium and A549 immortalized cell line

Background. Glaucoma as one of the most common eye diseases can be a comorbid condition of an epithelial corneal defect of various etiologies. Maintaining an optimal level of ophthalmotonus includes the prescription of antiglaucoma drugs, including benzalkonium chloride-preserved drugs.The aim of the study. To compare the effect of antiglaucoma drugs, as well as benzalkonium chloride (BC), on a primary culture of human corneal epithelium and A549 immortalized cell line.Methods. The effect of brimonidine, dorzolamide and timolol (1/100, 1/50, 1/20 and 1/10 dilutions; exposure 24 hours) on a monolayer of a human corneal epithelial primary culture and A549 immortalized cell line was assessed by structural changes in cells (phase-contrast microscopy) and MTT assay data. The cytotoxic effect of BC was studied in concentrations corresponding to its content in these dilutions of the antiglaucoma drug. Using a model of a linear defect in the monolayer of a corneal epithelial primary culture and A549 immortalized cell line, the effects of brimonidine, dorzolamide and timolol (1/100 and 1/20 dilutions; exposure 48 hours) were assessed by cell migration activity.Results. Among drugs (BC-free), dorzolamide (1/50, 1/20 and 1/10 dilutions) causes minor structural changes in human corneal epithelium and A549 immortalized cell line; timolol (1/100, 1/50, 1/20 and 1/10 dilutions) causes minor structural changes in A549 immortalized cell line. Structural changes in both types of cells, a decrease in their metabolic and migration activity occur under the influence of dorzolamide, brimonidine and timolol (BC-preserved) in 1/100, 1/50, 1/20 and 1/10 dilutions. BC at the studied concentrations exhibits a similar effect.Conclusion. The cytotoxic effect of antiglaucoma drugs is caused by the presence of BC in their composition. Despite similar morphofunctional changes in cells, A549 immortalized cell line is more resistant to the effects of drugs than the human corneal epithelial primary culture. When using it as a cellular model, it is advisable to change the experimental conditions (duration of exposure and concentration of the studied drug).

Formulation and evaluation of Dorzolamide hydrochloride microsponges loaded in situ gel for ocular administration

Due to the unique structure of the eye, which inhibits the entry of drug molecules into the desired site, the ophthalmic delivery of the drug has been one of the most challenging tasks for a pharmaceutical scientist. For this reason, in this investigation a novel microsponge for an anti-glaucoma drug, Dorzolamide hydrochloride, was formulated as in situ gel for ocular administration with an aim to improve its therapeutic efficacy and reduce the systemic adverse effects. The microsponges were prepared by the quasi emulsion solvent diffusion method and was incorporated into 20% pluronic F-127 which led to consistent in situ gel at 35°C. They were evaluated for physicochemical properties like pH, gelling capacity, gelation time, rheological properties and release profile and ocular irritancy test. The prepared Dorzolamide hydrochloride microsponges showed high entrapment efficiency of 85% and mean particle size of 2 μm with polydispersity index (PDI) of 0.77 which are ideal for ocular delivery. These microsponges is formulated into in situ gel which showed higher therapeutic efficacy compared to free drug in gel. It was found to be non-irritant to the rabbit’s eye. These results confirms that Dorzolamide hydrochloride microsponges in situ gels have promising features, benefits and advantages for a novel ophthalmic drug delivery to treat glaucoma.

The Application of Rho Kinase Inhibitors in the Management of Glaucoma.

Glaucoma is a chronic neurodegenerative disease that poses a significant threat of irreversible blindness worldwide. Current treatments for glaucoma focus on reducing intraocular pressure (IOP), which is the only modifiable risk factor. Traditional anti-glaucomatous agents, including carbonic anhydrase inhibitors, beta-blockers, alpha-2 agonists, and prostaglandin analogs, work by either improving uveoscleral outflow or reducing aqueous humor production. Rho kinase (ROCK) inhibitors represent a novel class of anti-glaucomatous drugs that have emerged from bench to bedside in the past decade, offering multifunctional characteristics. Unlike conventional medications, ROCK inhibitors directly target the trabecular meshwork outflow pathway. This review aims to discuss the mechanism of ROCK inhibitors in reducing IOP, providing neuroprotection, and preventing fibrosis. We also highlight recent studies and clinical trials evaluating the efficacy and safety of ROCK inhibitors, compare them with other clinical anti-glaucomatous medications, and outline future prospects for ROCK inhibitors in glaucoma treatment.

Comparison of Effects of Preserved and Preservative Free Anti-Glaucoma Drugs in Causing Dry Eyes

Objective: The aim of this study was to assess the potential impact of antiglaucoma medication preservatives on ocular surface health and the subsequent development of dry eye symptoms. Methods: A non-randomized controlled trial study was conducted from March 2023 to June 2023.The study enrolled 32 patients, with 16 participants in each group. Patients meeting the inclusion criteria, including confirmed diagnosis of glaucoma and stable ocular health, were allocated to Group A(preserved medication) or Group B(preservative-free medication).Tear Film Break-Up Time(TBUT) and Schirmer's test were employed as objective indicators of tear film stability and tear production respectively. Measurements were recorded at baseline and after a 3-month duration of medication use. Results: At 1st visit, mean TBUT was 10.87 sec and mean Schirmer's test was 13.75 mm in group A while in group B it was 11.25 sec and 14.56 mm respectively. After 3 months of medication use, mean TBUT and mean Schirmer’s was 9.62 sec and 11.81 mm respectively in group A while in group B it was 10.18 sec and 13.18 mm respectively. The results showed that initial ocular status was similar in both groups however the decrease in values showed ocular surface deterioration. Notably group A demonstrated a more substantial decline in tear production compared to group B. Conclusion: This study underscores the importance of both preserved and preservative-free anti-glaucoma medications. Although both may potentially exacerbate dry eye symptoms to a greater extent, preservative-free anti-glaucoma may offer benefits in maintaining ocular surface health with long-term use.

The Effect of Trabecular Aspiration on Intraocular Pressure, Medication and the Need for Further Glaucoma Surgery in Eyes with Pseudoexfoliation Glaucoma.

To investigate whether trabecular aspiration (TA) has an effective medium-term intraocular pressure (IOP)-lowering and medication-saving effect in patients with pseudoexfoliation glaucoma (PEG). In addition, a subgroup analysis of patients with or without a previous trabeculectomy was performed. Records of 290 consecutive eyes with PEG that underwent TA between 2006 and 2012 at the Department of Ophthalmology, Mainz, Germany, were retrospectively analyzed with a follow-up period of 3 years. The main outcomes were IOP and the need for further medical treatment. Of the 290 eyes with PEG that received TA, 167 eyes from 127 patients met the inclusion criteria. Among these eyes, 128 received TA and cataract surgery (Phaco-TA) without having had a trabeculectomy (group I) before, 29 had Phaco-TA after a previous trabeculectomy (group II) and 10 underwent stand-alone TA after a previous trabeculectomy (group III). In the whole cohort, the median IOP decreased immediately after TA and remained significantly lower compared to the baseline throughout the period of 36 months. Likewise, the median number of antiglaucoma drugs was reduced over the whole period. At the same time, in group I, the median IOP and the number of antiglaucoma drugs were reduced over 36 months. In contrast, in the post-trabeculectomy groups (group II and III), the median IOP and the number of antiglaucoma drugs could not be reduced. While most of the patients that received Phaco-TA with or without a previous trabeculectomy (group I and II) did not require further surgical intervention during the follow-up period, almost all patients receiving stand-alone TA after a previous trabeculectomy (group III) needed surgical therapy, most of them between the second and the third year following TA. Phaco-TA has an effective medium-term pressure-lowering and medication-saving effect, especially in patients without a previous trabeculectomy. In trabeculectomized eyes, the effect of TA is limited but still large enough to delay more invasive surgical interventions in some patients.

Prevalence of dry eye in patients using topical antiglaucoma medications

Aim: Topical antiglaucoma drugs may have adverse effects on the ocular surface. In this study, our aim was to report the frequency of dry eye and the use of artificial tear drops in patients diagnosed with glaucoma and using topical antiglaucoma drugs. We also evaluated factors affecting this association. Methods: Based on the medical records, we selected patients admitted to the ophthalmology department between 2020 and 2021 who had been diagnosed with glaucoma. In this study, we included patients who were using topical antiglaucoma medications and were older than 40 years of age. Age, gender, type, and number of glaucoma medications used, dry eye diagnosis, and use of artificial tear drops and/or topical cyclosporine were recorded. Results: We found that 346 (27%) of the 1,274 patients using topical antiglaucoma drugs had dry eyes and were using artificial tear drops. Gender (female) and the number of antiglaucoma medications used were associated with an increased risk of dry eye in these patients, while increasing age was not associated with dry eye. Conclusion: Dry eye is common in patients using topical antiglaucoma medications and should be considered in the treatment of glaucoma.

Understanding the treatment paradigm and the sequencing of antiglaucoma fixed-dose combinations in a tertiary center in South India.

To analyze the medical management of primary open-angle glaucoma (POAG) and ocular hypertension (OHT) and the placement of fixed-drug combination drugs (FDC) in the treatment paradigm at a tertiary eye care center in South India. Retrospective study (January 2011-December 2015) of newly diagnosed POAG and OHT patients (≥18 years) with ≥5 years follow-up. Primary outcome included percentage use of different antiglaucoma drugs (at initiation) and FDCs at the first, second, and third progression (sequencing). Secondary outcomes: Percentage discontinuation for different FDCs, efficacy parameters (decrease in intraocular pressure (IOP)/visual field), adverse events, and the median number of antiglaucoma medications (AGMs) after 5 years. Three hundred and seventy eyes (198 patients) were analyzed; 84% of them had POAG. Prostaglandin analogs (PGAs) were the most common (66.2%). FDCs were started in 48 eyes (12.9%), with brimonidine + timolol combination being the most common. FDC usage at subsequent modifications was 10.1%, 24.04%, and 30.0%. Beta-blockers and PGAs were the most frequently prescribed AGMs in our practice pattern, with β-blockers being the most consistent one. This study is a fairly large study with a minimum of a 5-year follow-up of patients with POAG and OHT and gives insights into the treatment patterns, use of FDCs, and the need for multiple medications over time.

Colorimetric Concurrent Determination of Ultra-Trace Amounts of Pilocarpine and Timolol as Anti-Glaucoma Drugs in Binary Mixtures Using a Multivariate Calibration Approach Based on the Aggregation of Gold Nanoparticles.

To study the ultra-trace simultaneous determination of drugs, the colorimetric method in combination with chemometrics can be used. In this study, a simple, rapid, and sensitive UV-Vis spectrophotometric method using gold nanoparticles (AuNPs) was introduced for the simultaneous determination of ultra-trace amounts of pilocarpine (PIL) and timolol (TIM) in binary mixtures and biological samples. AuNPs interacted with components and the aggregation mode of NPs occurred, and, finally, the color change of the solution (red to gray) was observed with the naked eye without the most modern and expensive instruments. The characterization of AuNPs was evaluated by transmission electron microscopy (TEM) and dynamic light scattering (DLS). The validation of the colorimetric way was studied in the concentration range of 100-800 and 100-600 μg/L with good linearity equal to 0.9772 and 0.9891 for PIL and TIM, respectively. The limit of detection (LOD) was found to be 165.00 and 92.40 μg/L, where the limit of quantitation (LOQ) was 500.00 and 280.00 μg/L for PIL and TIM, respectively. The effect of some factors such as interaction time, the concentration of components, and the volume of buffer on absorbance was investigated. Partial least squares (PLS) as an efficient multivariate calibration method was combined with colorimetry for the simultaneous determination of PIL and TIM in binary mixtures. The optimum number of latent variables was selected by k-fold cross-validation based on minimum mean square error prediction (MSEP), and the number of components equal to 1 with MSEP of 1.085 and 0.763 was considered for PIL and TIM, respectively. The mean recovery was obtained at 100.20 and 101.55% for PIL and TIM, respectively. The colorimetric method can be introduced as a proper option for the simultaneous determination of components in pharmaceutical formulations and other samples. A colorimetric method using AuNPs was proposed. The PLS method was coupled with a colorimetric method for the ultra-trace simultaneous estimation of PIL and TIM in binary mixtures. Ultra-trace amounts of PIL and TIM were also determined in biological samples. The proposed method is simple, fast, and less expensive than chromatography methods.

PREVALENCE, INCIDENCES AND MANAGEMENT PRACTICES OF OPHTHALMIC EMERGENCIES; A CROSS-SECTIONAL STUDY IN JINJA REGIONAL REFERRAL HOSPITAL.

Introduction This study was aimed at establishing the prevalence of ophthalmic emergencies, determining the common incidences of ophthalmic emergencies, and establishing the common management practices of ophthalmic emergencies at Jinja Regional Referral Hospital. This study was carried out at the eye department of Jinja Regional Referral Hospital, Jinja City Busoga region Methodology It employed a descriptive cross-sectional study design that employed both qualitative and quantitative methods of data collection from a sample size of 100 using a self-administered questionnaire. Data was analyzed manually and presented in tables and figures. Results The study showed that 43(43%) of the respondents were 10-20 years old and 60(60%) of them were males. Most of the respondents affected 42(42%) were those who were working in industries, factories, and welding. The most common ophthalmic emergency incidences were open globe injuries 72(72%) and mostly corneal foreign bodies 42(42%). The common management options for ophthalmic emergencies present at JRRH were both topical and systemic antibiotics, anti-fungal anti-viral drugs depending on the cause of the illness; surgery; topical or systemic steroids to reduce inflammation in the eye; anti-glaucoma drugs to reduce IOPs and referral Conclusion The study concluded that the common age group affected by ophthalmic emergencies is 10-20 years and mostly males are affected and with those working, it was mostly welders, those working in industries, factories, and peasants. Recommendations The government, Ophthalmologists, ophthalmic clinical officers, and ophthalmic nurses should play their roles to address the challenges in service delivery to reduce ophthalmic emergencies or even avoid complications of ophthalmic emergencies

Swiss Multicenter Ab Interno XEN45 Gel Stent Study: 2-Year Real-World Data.

The aim of this study was to investigate the 2-year postoperative efficacy of the XEN45 Gel Stent by evaluating the reduction of intraocular pressure (IOP) and the need for eye pressure-lowering medications in a multicenter setting in Switzerland. Patients with various types of glaucoma who received a XEN45 Gel Stent with or without combined phacoemulsification cataract surgery at five hospitals in Switzerland were retrospectively enrolled. Pre- and postoperative IOP, the number of antiglaucoma medications, and the need of subsequent interventions to control IOP were assessed. The success rate was defined as a ≥ 20% reduction of IOP 2years postoperatively without the need for subsequent glaucoma surgery. A total of 345 eyes were included: 44.3% with primary open-angle, 42.0% pseudoexfoliation, and 13.7% with other types of glaucoma. Of these, 206 patients were followed for 2years. Preoperatively, the mean IOP was 26.3 ± 8.9mmHg and the mean number of antiglaucoma medications administered was 3.0 ± 1.3. Two years postoperatively, the success rate was 66.0% (95% confidence interval 59.3-72.1%), the IOP had dropped by 43.8% to 14.8 ± 5.7mmHg, and the number of medications was reduced by a mean of 2.0 ± 1.7 per day. Postoperative complications and the need for interventions remained low. The XEN45 Gel Stent successfully reduced IOP and the number of antiglaucoma drugs in most patients at 2years postoperatively.

An interventional study on awareness, knowledge and services provided for the diagnosis and treatment of glaucoma by optometrists in primary healthcare centre of Kolar district

Aim of this study was to assess the awareness, knowledge services provided for glaucoma among optometrists at primary health care.A cross-sectional questionnaire based study involving 36 Optometrists from Primary Healthcare Centre and government hospitals of Kolar and Chikkaballapur district, who participated in the ‘World Glaucoma awareness program’. The responses were compiled and analyzed for each category of questions using paired t test.Out of 36 participants 31 (86.11%) were males and 5 (13.89%) were females with an average age of 39.42+10.5 years and average duration of service in PHC/CHC/Taluk Hospital was 14.08 years. Among them 88.9% were aware about glaucoma being a disease due to increased intra ocular pressure (IOP). Although 69.4% knew that it leads to irreversible blindness, 75% were unaware of the symptoms that glaucoma presents with. 53% were unaware of the normal IOP of the eye and 41.7% the test to detect the same. 33.3% of hospitals had Shiotz tonometer but only 22.2% were aware of testing the IOP and peripheral visual field for diagnosing glaucoma. 61.1% were not familiar with any antiglaucoma drug and 52.8% about the duration of treatment. Post-test analysis was statistically significant with respect to the Awareness, Knowledge and Services (P=0.001, P=0.001, P=0.001).This study reveals the lacunae and highlights the importance of routine eye examination of rural population by Optometrists for early detection of glaucoma through improved services and timely referral to Ophthalmologists for further evaluation, thereby reducing the burden of visual impairment.