A Novel 8-mm Schlemm's Canal Scaffold Reduces Outflow Resistance in a Human Anterior Segment Perfusion Model

Gulati, Vikas; Fan, Shan; Hays, Cassandra L.; Samuelson, Thomas W.; Ahmed, Iqbal Ike K.; Toris, Carol B.

doi:10.1167/iovs.12-11373

Cited by 51 publications

(42 citation statements)

References 25 publications

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“…While the present cause-and-effect relationship was IOP perturbation leading to morphometric response, the same relationship has been observed with a morphometric perturbation leading to IOP response. Gulati et al 22 implanted a scaffold in SC, inducing a large increase in SC-CSA. 22 This morphometric alteration resulted in a decrease in IOP.…”

Section: Discussionmentioning

confidence: 99%

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IOP Elevation Reduces Schlemm's Canal Cross-Sectional Area

Kagemann

Wang

Wollstein

et al. 2014

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Previously, we demonstrated reduced Schlemm's canal cross-sectional area (SC-CSA) with increased perfusion pressure in a cadaveric flow model. The purpose of the present study was to determine the effect of acute IOP elevation on SC-CSA in living human eyes. METHODS.The temporal limbus of 27 eyes of 14 healthy subjects (10 male, 4 female, age 36 6 13 years) was imaged by spectral-domain optical coherence tomography at baseline and with IOP elevation (ophthalmodynamometer set at 30-g force). Intraocular pressure was measured at baseline and with IOP elevation by Goldmann applanation tonometry. Vascular landmarks were used to identify corresponding locations in baseline and IOP elevation scan volumes. Schlemm's canal CSA at five locations within a 1-mm length of SC was measured in ImageJ as described previously. A linear mixed-effects model quantified the effect of IOP elevation on SC-CSA.RESULTS. The mean IOP increase was 189%, and the mean SC-CSA decrease was 32% (P < 0.001). The estimate (95% confidence interval) for SC-CSA response to IOP change was À66.6 (À80.6 to À52.7) lm 2 /mm Hg.CONCLUSIONS. Acute IOP elevation significantly reduces SC-CSA in healthy eyes. Acute dynamic response to IOP elevation may be a useful future characterization of ocular health in the management of glaucoma.

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Section: Discussionmentioning

confidence: 99%

“…Gulati et al 22 implanted a scaffold in SC, inducing a large increase in SC-CSA. 22 This morphometric alteration resulted in a decrease in IOP. The same concept may be applied to monitor the effects of minimally invasive nonpenetrating glaucoma procedures and implantation of devices designed to bypass the trabecular network.…”

Section: Discussionmentioning

confidence: 99%

IOP Elevation Reduces Schlemm's Canal Cross-Sectional Area

Kagemann

Wang

Wollstein

et al. 2014

Invest. Ophthalmol. Vis. Sci.

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“…23 Multiple laboratory studies examining the Hydrus Microstent using human cadaveric tissue in an anterior segment perfusion model have demonstrated an increase in outflow facility compared with untreated controls. 24,25 …”

Section: Study Devicementioning

confidence: 99%

A Randomized Trial of a Schlemm's Canal Microstent with Phacoemulsification for Reducing Intraocular Pressure in Open-Angle Glaucoma

et al. 2015

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“…Since a low baseline IOP may lead to an insignificant IOP reduction, we also examined the IOP responses at a higher perfusion rate of 10 µl/min at the baseline and after the first and second TM removal processes. If any clear signs of leakage (IOP< 5 mmHg at the baseline), contamination or obstruction (IOP>50 mmHg at any point) were observed at any time during the process, the samples were removed from the experiment [20].…”

Section: Porcine Eye Perfusion Culture Iop and Outflow Facilitymentioning

confidence: 99%

Outflow Enhancement by Three Different ab Interno Trabeculectomy Procedures in a Porcine Anterior Segment Model

Dang¹,

Wang²,

Shah³

et al. 2018

Preprint

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Objective: To evaluate three different microincisional ab interno trabeculectomy procedures in a porcine eye perfusion model. Methods:In perfused porcine anterior segments, 90 degrees of trabecular meshwork (TM) were ablated using the Trabectome (T; n=8), Goniotome (G; n=8), or Kahook device (K; n=8). After 24 hours, additional 90 degrees of TM were removed. Intraocular pressure (IOP) and outflow facility were measured at 5 µl/min and 10 µl/min perfusion to simulate an elevated IOP. Structure and function were assessed with canalograms and histology.Results: At 5 µl/min infusion rate, T resulted in a greater IOP reduction than G or K from baseline (76.12% decrease versus 48.19% and 47.96%, P=0.013). IOP reduction between G and K was similar (P=0.420). Removing another 90 degrees of TM caused an additional IOP reduction only in T and G but not in K. Similarly, T resulted in the largest increase in outflow facility at 5 µl/min compared with G and K (first ablation: 3.41 times increase versus 1.95 and 1.87; second ablation: 4.60 versus 2.50 and 1.74) with similar results at 10 µl/min (first ablation: 3.28 versus 2.29 and 1.90 (P=0.001); second ablation: 4.10 versus 3.01 and 2.01 (P=0.001)). Canalograms indicated circumferential flow beyond the ablation endpoints.Conclusions: T, G and K significantly increased the outflow facility. In this model, T had a larger effect than G and K.

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A Novel 8-mm Schlemm's Canal Scaffold Reduces Outflow Resistance in a Human Anterior Segment Perfusion Model

Cited by 51 publications

References 25 publications

IOP Elevation Reduces Schlemm's Canal Cross-Sectional Area

IOP Elevation Reduces Schlemm's Canal Cross-Sectional Area

A Randomized Trial of a Schlemm's Canal Microstent with Phacoemulsification for Reducing Intraocular Pressure in Open-Angle Glaucoma

Outflow Enhancement by Three Different ab Interno Trabeculectomy Procedures in a Porcine Anterior Segment Model

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