Ab externo device for the treatment of glaucoma: direct flow from the anterior chamber to the ocular surface

Schultz, Tim; Schojai, Merita; Kersten-Gomez, Inga; Elling, Matthias; Boecker, Joerg; Dick, H. Burkhard

doi:10.1097/j.jcrs.0000000000000202

Cited by 9 publications

(11 citation statements)

References 5 publications

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“…Die minimal-invasive Glaukomchirurgie, kurz MIGS genannt, ist aufgrund effizienter Drucksenkung und guten Sicherheitsprofils in vielen Fällen eine gute Alternative zur Trabekulektomie (TET) [ 3 ]. Das Microshunt-Implantat lässt sich im Gegensatz zur TET in Kombination mit einer Kataraktoperation ab externo implantieren, ohne dass ein nachteiliger Effekt entsteht [ 2 , 7 ]. Jedoch ist auch bei minimal-invasiven Verfahren die postoperative Entzündungsprophylaxe mit Steroiden von entscheidender Bedeutung für den Erfolg der Operation, im Speziellen bei kombinierten Verfahren [ 9 ].…”

Section: Diskussionunclassified

Trübung der Intraokularlinse nach kombinierter Katarakt- und minimal-invasiver Glaukomchirurgie (MIGS)

2020

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ZusammenfassungDrei Wochen nach komplikationsloser kombinierter minimal-invasiver Glaukom- und Kataraktoperation kam es zu einer Sehverschlechterung durch die Eintrübung der Intraokularlinse. Durch die Nichtanwendung der postoperativen antiinflammatorischen Lokaltherapie kam es zu einer homogenen Fibrinbildung auf der Linsenvorderfläche sowie einer beginnenden Vernarbung des Sickerkissens. Wir führten ein Needling mit 5‑Fluorouracil sowie eine Linsenpolitur mit dem Nd:YAG-Laser durch und erreichten so eine suffiziente Druckkontrolle und Sehverbesserung.

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Section: Diskussionunclassified

Trübung der Intraokularlinse nach kombinierter Katarakt- und minimal-invasiver Glaukomchirurgie (MIGS)

2020

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“…In a recent initial human clinical trial, the BAMs have been implanted in 5 eyes of 5 patients. 40 After implantation, the IOP went down immediately, and all patients showed a continuous central outflow of the AH with no paraxial leakage, no severe complications or any unpleasant sensation at the eye's surface. The current results have shown that the BAMs seem to be easy-to-operate and promising devices.…”

Section: Microfluidics Of Minimally Invasive Glaucoma Surgery (Migs) ...mentioning

confidence: 80%

“…2b), suprachoroidal space (beneath the sclera), conjunctival space (the outlet of GDDs), 38,39 or less commonly to the extraocular tear film. [40][41][42] Such device implantations often have limited Fig. 1 Schematic representation of aqueous dynamics.…”

Section: Tingrui Panmentioning

confidence: 99%

“…[251][252][253][254][255][256] The safety of the extraocular route has been preliminarily confirmed by both animal studies and clinical trials using the pioneering Beacon Aqueous Microshunt, in which no substantial infectious adverse events are observed. 257 That being said, a greater safety can be achieved by incorporating a one-way valve into the extraocular implants so that the infection issues can be completely circumvented.…”

Section: Comparison Of Flow and Pressure Regulation Characteristicsmentioning

confidence: 99%

“…2b), suprachoroidal space (beneath the sclera), conjunctival space (the outlet of GDDs), 38,39 or less commonly to the extraocular tear film. 40–42 Such device implantations often have limited surgical manipulation of the sclera and negligible influence on the conjunctiva. Therefore, MIGS devices provide an attractive and often reasonably effective surgical option using minimally invasive techniques, falling between the conservative treatments ( e.g.…”

Section: Introductionmentioning

confidence: 99%

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Microfluidics in the eye: a review of glaucoma implants from an engineering perspective

Fang,

Bi,

Brown

et al. 2023

Lab Chip

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Droplet Laplace valve‐enabled glaucoma implant for intraocular pressure management

Wang,

Fang,

et al. 2024

Droplet

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Glaucoma, the leading cause of irreversible blindness worldwide, is closely linked to aqueous overaccumulation and elevated intraocular pressure (IOP). For refractory glaucoma, aqueous shunts with valves are commonly implanted for effective aqueous drainage control and IOP stabilization. However, existing valved glaucoma implants have the disadvantages of inconsistent valve opening/closing pressures, poor long‐term repeatability due to their reliance on moving parts, and complex architectures and fabrication processes. Here, we propose a novel valving concept, the droplet Laplace valve (DLV), a three‐dimensional printable moving‐parts‐free microvalve with customizable and consistent threshold valving pressures. The DLV uses a flow discretization unit governed by capillarity, comprising a droplet‐forming nozzle, and a separated reservoir to digitize continuous flow into quantifiable droplets. Unlike the classic one‐time‐use Laplace valves, the DLV's unique design allows for its reusability. The opening pressure is adjustable by varying the nozzle size, like the classic Laplace valves (following the Young–Laplace equation), while the closing pressure can be modified by tuning the separation distance and the reservoir size. Various DLVs with customizable opening pressures from 5 to 11 mmHg have been demonstrated, with opening/closing pressure differences suppressed down to <0.5 mmHg (<0.15 mmHg under the best conditions). Thanks to its moving‐parts‐free nature and digitized flow properties, the DLV shows a highly repeatable valving performance (<1.7%, 1000 cycles) and a predictable linear flow rate–pressure correlation (R2 > 0.99). Preliminary ex vivo validation in an enucleated porcine eye confirms the DLV's efficiency in aqueous shunting and prompt IOP stabilization. The DLV technology holds great promise in glaucoma implants for IOP management and various microsystems for flow control.

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Ab externo device for the treatment of glaucoma: direct flow from the anterior chamber to the ocular surface

Cited by 9 publications

References 5 publications

Trübung der Intraokularlinse nach kombinierter Katarakt- und minimal-invasiver Glaukomchirurgie (MIGS)

Trübung der Intraokularlinse nach kombinierter Katarakt- und minimal-invasiver Glaukomchirurgie (MIGS)

Microfluidics in the eye: a review of glaucoma implants from an engineering perspective

Droplet Laplace valve‐enabled glaucoma implant for intraocular pressure management

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