Dr. Matthew Nutaitis of MUSC's Storm Eye Institute discusses recent developments in the treatment of glaucoma.
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Host: Are there any new developments in the treatment of Glaucoma? Dr. Matthew J. Nutaitis: In the last 10 years or so, we've got some really good medicines that have a lower complication rate in broader spectrum of patients that they work in. The one group that is really made a big difference in really everybody's life the patients and the doctors are trying to cure would be the prostaglandins and their analogs. These work on the outflow system, and it's the uveoscleral outflow system -- 10% group I was talking about. So those are that's the fantastic group of medicines and very powerful. Now we're looking for more medicines and what really has been studied now is a chance to look at protective substances. Things that protect your optic nerve from hair and troubles. And we are not making a lot of headway, there are some animal studies has been done, but really nothing that applies to the human optic nerve that is useful for declinations but I am hoping in the next 10 or 20 years to get some advancement on that. There is a couple of new lasers that are out, they don't tend to add a lot more than the lasers we have, but there is proponents that think that these are better or easier or more effective than some of the older treatments we have. So that's yet to be seen, and then there is certainly new surgical techniques and substances that we can use in surgery that help modulate wound healing which is the biggest enemy to successful glaucoma surgeries that your own healing system wins and heals things up you start over again. And then there is a thought to take some of the glaucoma valve so we put a certain artificial silicone structuring in your eye to kind of pull the fluid out of your eye, but when those fail, again this healing system of the body is winning. So they are taking about impregnating those structures with anti-fibrotics medicines and giving you a higher success rate. So -- but we are still not satisfied that we've got something that's going work for everybody pretty reliably, still take some, I am old enough to say this and just basically good old fashioned doctrine where you have to know your patient, you have to understand what they need and what they want and then you have to be able to have conversation with them, so that they understand what you can provide and then in that doctor-patient relationship you together and you decide how you're going to proceed with those. The other thing that is come up is how about an optic nerve transplant. Let's just take somebody else's optic nerve and put in your eye, but there is 1.2 million axons in getting all these connections right, is just not going to happen, probably in our life time. So you got to get it before it gets to the DMV diagnosis stage.
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