Benchè sia ormai "vecchia" di 9 mesi, questa risposta del Dr. Sebag non mi pare purtroppo molto incoraggiante... Almeno non nel breve-medio periodo... _________________ T E X = [Moderatore]
Dr. Sebag Answers On Microplasmin
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Microplasmin will be considered by the FDA for approval in cases with vitreo-macular traction, nothing else. If approved, I suspect that there will be those who attempt to use it 'off-label' to treat floaters. I don't know if the enzyme at the approved dose will be able to break down the floaters. A higher dose would probably not be safe, or at least we don't know about higher doses than those that were tested until a study is done with higher doses.
Floaters are not the same structures as what we measured in our study. In fact, there is reason to question whether micropalsmin might not even increase floaters. While this hasn't been noticed in our research so far, the only way to determine if microplasmin is safe and effective in treating floaters is to perform a controlled, double-blind, multi-center clinical trial of hundreds of patients with floaters. Then we will know the answer to your questions.
Sincerely yours, JS
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J. Sebag, MD, FACS, FRCOphth, FARVO
Professor of Clinical Ophthalmology
University of Southern California
contact info:
VMR Institute, a Medical Corporation
7677 Center Avenue, suite 400
Huntington Beach, CA 92647
Tel: 714-901-7777
Fax: 714-901-7770
jsebag@VMRinstitute.com www.VMRinstitute.com
Ciao
Ecco una email fresca fresca appena ricevuta da J.Sebag
Jerry Sebag 08 August at 19:46 Report
There will one day be a drug injection (Sebag J: Pharmacologic vitreolysis – premise and promise of the first decade. Retina 29:871-4, 2009), but that may be a decade or more away. Today, I perform minimally invasive, sutureless vitrectomy that takes 10 minutes under local anesthesia in an out-patient surgery center. Please call 714-901-7777 to schedule an appointment. Sincerely, J. Sebag, MD, FACS, FRCOphth, FARVO
Ecco il link della sua ultima pubblicazione in merito all- argomento
Jerry Sebag 8 agosto alle 19:46 Report
Ci sarà un giorno una iniezione di droga (Sebag J: vitreolysis farmacologico - premessa e la promessa del primo decennio. Retina 29:871-4, 2009), ma che può essere un decennio o più di distanza. Oggi, pratico vitrectomie mini invasive, vitrectomie sutureless che durano 10 minuti in anestesia locale in un centro di chirurgia ambulatoriale. Si prega di chiamare 714-901-7777 per programmare un appuntamento. Cordiali saluti, J. Sebag, MD, FACS, FRCOphth, FARVO
I think what Sebag is saying is that an injection that will do the vitrectomy all by itself is he believes still a decade away.
In my understanding there are two problems that make the vitrectomy surgery untrivial. The first one is the problems during the surgery such as retinal damage. Enzymatic vitrectomy can improve this part. The second one is the post-surgery problems such as cataracts, retina eudema, changed eye pressure, etc. Post-surgery problems are because there is yet no good artificial vitreous replacement gel. During vitrectomy surgery, the surgeons fill the eye with something, and then the eye segretes its anterior chamber liquid to replace that something.
If done in good hands, I believe the surgical problems can be minimized even with today's medical techniques. However, the post-surgical problems will be there and they will cause a series of other surgeries like cataracts. So the most major problem with the vitrectomy operation is that there is no good artificial vitreous replacement gel.
Floater patients are only a very small minority of patients who are considered for vitrectomy. There are hundreds of thousands if not milions of vitrectomy operations performed every year and every surgeon would like to see the availability of such a gel.
So you should ask Dr Sebag why the opthalomologists could still not develop this gel. I am an engineer, and we can communicate over thousands of kilometers over fiber optic cable. This is no less technological challenge than the development of a vitreous replacement gel. Why is this part of the modern medicine so "backward"?
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