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Tackling Scarring, Improving Outcomes

When it comes to intraocular pressure (IOP) reduction in glaucoma management, filtration surgery – a field of impressive innovation – has compelling advantages over nonsurgical treatments. But it also has limitations; namely, bleb management remains challenging because of post-operative scarring. What current options exist to prevent scarring? Intraoperative application of chemotherapy drugs (for example, mitomycin-C) is not only complex and time consuming, but it also comes with a failure rate approaching 50 percent at three years.

Beta therapy has been shown to significantly improve glaucoma filtration surgery outcomes in three randomized controlled clinical studies (1,2). The most recent of these studies reported odds ratios indicating that beta irradiation therapy patients were five and a half times more likely to experience lower IOP at the end of one year than patients treated with antimetabolite mitomycin-C (3). Beta therapy fits well into the surgical workflow and reduces scarring by using beta irradiation to down-regulate the fibroblasts at the heart of the scarring process – thus helping to maintain reduced IOP (notably, while minimizing stray dosing to non-target tissues). Beta therapy also avoids exposing medical staff to hazardous chemotherapy drugs, such as mitomycin-C – the current standard of care.

“For glaucoma surgery to be successful, anti-scarring therapies must be effective, consistent in dosage, and fast and easy to administer – beta therapy is all three,” said Sir Peng Khaw, Professor of Glaucoma Studies and Wound Healing, and member of the Board of Directors at Radiance Therapeutics. 

Enter Radiance Therapeutics, Inc.: a new company developing a device for the topical application of beta therapy for trabeculectomies or MIGS drainage device implantation sites. 

Sir Peng Khaw has the final word: “In combination with new drainage devices, beta therapy could revolutionize the treatment of glaucoma.”

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  1. Kirwan, JF et al. Effect of Beta radiation on success of glaucoma drainage surgery in South Africa: randomised controlled trial. BMJ, doi:10.1136/bmj.38971.395301.7C (published 5 October 2006)
  2. Dhalia, K et al. Is Beta Radiation Better than 5 Flurouracil as an Adjunct for Trabeculectomy Surgery When Combined with Cataract Surgery? A Randomized Controlled Trial. PloS ONE 11(9).
  3. Cook, C., et al. Trial Registry DOH-27-0117-4030. Pending Publication.
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