A prospective, open-label, dose-escalating study of low molecular weight heparin during repeat vitrectomy for PVR and severe diabetic retinopathy

Lane, R; Jumper, J. Michael; Nasir, Maʼan; MacCumber, Mathew W.; McCuen, Brooks W.

doi:10.1007/s00417-004-0912-0

Cited by 9 publications

(6 citation statements)

References 9 publications

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“…One very striking example of this is delineated in a recent article by Sullu et al [23] describing how PPV may decrease the resistive index and improve blood flow through the retinal vessels. Some investigators have reported the application of intravitreal heparin infusion as an aid to removing clotting preretinal hemorrhage intraoperatively [24], as well as the use of low molecular weight heparin (enoxaprin) in the infusion to help decrease the formation of postvitrectomy fibrin [27]. Others have introduced the idea of perfluorocarbon-perfused PPV, which may offer advantages over Balanced Salt Solution infusion in terms of immiscibility with bodily fluids, ability to transport oxygen and gravitational forces [28].…”

Section: Vitrectomy Then and Nowmentioning

confidence: 97%

Diabetic vitrectomy: risks, prognosis, future trends

Mason

Colagross

Vail

2006

Current Opinion in Ophthalmology

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Section: Vitrectomy Then and Nowmentioning

confidence: 97%

Diabetic vitrectomy: risks, prognosis, future trends

Mason

Colagross

Vail

2006

Current Opinion in Ophthalmology

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“…Intravitreal heparin may be injected to remove pre-retinal clotted blood[ 64 ] and low-molecular-weight heparin (enoxaparin) has been added to the infusion bottle to reduce the formation of post-vitrectomy fibrin. [ 77 ]…”

Section: Managementmentioning

confidence: 99%

Current management of diabetic tractional retinal detachments

Stewart

Browning

Landers

2018

Indian J Ophthalmol

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Twenty-five percent of diabetes-related vision loss stems from complications of proliferative diabetic retinopathy (PDR). Panretinal photocoagulation has been the preferred treatment of high-risk PDR for decades and more recently intravitreal injections of drugs that inhibit the actions of vascular endothelial growth factor have become popular. But despite these treatments PDR may progress uncontrollably to advanced pathologies such as traction retinal detachments (TRDs), combined traction/rhegmatogenous retinal detachments (TRD/RRDs), vitreous hemorrhages, rubeosis iridis, and traction maculopathies, which produce mild-to-severe loss of vision. TDR have long been the most common indication for PDR-related vitreoretinal surgery. Vitrectomy surgery is indicated for recent (<6 months duration) TRD involving the macula, progressive TRD that threatens the macula, and recent data suggest that chronic macula-involving TRDs (>6 months duration) may also benefit. Combined TRD/RRD represents a particularly challenging surgical condition but advances in surgical instrumentation, dissection techniques, and post-operative tamponade have produced excellent success rates. The recent development of small-gauge vitrectomy systems has persuaded most surgeons to switch platforms since these appear to produce shorter surgical times and quicker post-operative recoveries. Pre-operative injections of bevacizumab are frequently administered for persistent neovascularization to facilitate surgical dissection of pre-retinal fibrosis and reduce the incidence of post-operative hemorrhages. Recent trends toward earlier surgical intervention and expanded indications are likely to continue as surgical instrumentation and techniques are further developed.

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“…Moreover, low molecular weight heparin has been shown to reduce postoperative fibrin formation after vitrectomy, in a rabbit model, with fewer haematological complications compared with non-fractionated heparin [49]. These findings were recently confirmed in patients with advanced PVR or severe diabetic retinopathy [50,51].…”

Section: Drug Treatment Of Pvrmentioning

confidence: 88%

Delivery Systems for the Treatment of Proliferative Vitreoretinopathy: Materials, Devices and Colloidal Carriers

Guidetti

Azema²,

Malet-Martino

et al. 2008

CDD

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Proliferative vitreoretinopathy (PVR), the most serious complication causing retinal detachment surgery to fail, is one of the leading causes of vision-loss in developed countries. The pharmaceutical treatment of this disease, located in the posterior segment of the eye, is problematic because it is difficult to achieve effective drug levels in the vitreous and the retina through conventional forms of administration (topical or systemic). Intravitreal injections can deliver drugs to the retina without the side-effects associated with systemic administration. However, because PVR is a long-term complication and the half-life of most drugs in the vitreous cavity is short, repeated injections are needed but this can cause complications. Recent advances in ocular drug delivery methods and the development of novel bioactive compounds could lead to new ways for the treatment of PVR. This review will summarize recent literature concerning intraocular drug delivery of biopharmaceutical agents for the treatment and prevention of PVR.

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A prospective, open-label, dose-escalating study of low molecular weight heparin during repeat vitrectomy for PVR and severe diabetic retinopathy

Abstract: Enoxaparin dose escalation did not result in a dose-dependent increase in acute side effects. The establishment of a well-tolerated dose of enoxaparin during repeat vitrectomy for PVR and severe diabetic retinopathy (6.0 IU/ml) provides a foundation for future studies.

Cited by 9 publications

References 9 publications

Diabetic vitrectomy: risks, prognosis, future trends

Diabetic vitrectomy: risks, prognosis, future trends

Current management of diabetic tractional retinal detachments

Delivery Systems for the Treatment of Proliferative Vitreoretinopathy: Materials, Devices and Colloidal Carriers

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