Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, Nebraska.
Invest Ophthalmol Vis Sci. 2014 Mar 28;55(3):1893-900. doi: 10.1167/iovs.13-13353.
To determine improvement in outflow facility (C) in human anterior segments implanted with a novel Schlemm's canal scaffold or two trabecular micro-bypasses.
Human anterior segments were isolated from 12 pairs of eyes from donors with no history of ocular disease and then perfused at 50, 40, 30, 20, and 10 mm Hg pressures for 10 minutes each. Baseline C was calculated from perfusion pressures and flow rates. The scaffold was implanted into Schlemm's canal of one anterior segment, and two micro-bypasses were implanted three clock-hours apart in the contralateral anterior segment. Outflow facility and resistance were compared at various standardized perfusion pressures and between each device.
Compared to baseline, C increased by 0.16 ± 0.12 μL/min/mm Hg (74%) with the scaffold, and 0.08 ± 0.12 μL/min/mm Hg (34%) with two micro-bypasses. The scaffold increased C at perfusion pressures of 50, 40, 30, and 20 mm Hg (P < 0.005). Two micro-bypasses increased C at a perfusion pressure of 40 mm Hg (P < 0.05).
Both implants effectively increased C in human eyes ex vivo. The scaffold increased C by a greater percentage (73% vs. 34%) and at a greater range of perfusion pressures (20 to 50 mm Hg vs. 40 mm Hg) than the two micro-bypasses, suggesting that the 8-mm dilation of Schlemm's canal by the scaffold may have additional benefits in lowering the outflow resistance. The Hydrus Microstent scaffold may be an effective therapy for increasing outflow facility and thus reducing the IOP in patients with glaucoma.
确定植入新型小梁网-Schlemm 管支架或两个小梁微旁路后人类眼前节房水流出系数（C）的改善情况。
从无眼部疾病史的 12 对供体的眼前节中分离出人类眼前节，并在 50、40、30、20 和 10mmHg 的压力下分别灌注 10 分钟。从灌注压力和流量计算出基础 C 值。将支架植入一只眼前节的小梁网-Schlemm 管中，将两个微旁路以三个时钟小时的间隔植入对侧眼前节。在各种标准化灌注压力下比较流出系数和阻力，并在每个装置之间进行比较。
与基线相比，支架组 C 值增加了 0.16±0.12μL/min/mm Hg（74%），微旁路组增加了 0.08±0.12μL/min/mm Hg（34%）。支架在 50、40、30 和 20mmHg 的灌注压力下增加了 C 值（P<0.005）。两个微旁路在 40mmHg 的灌注压力下增加了 C 值（P<0.05）。
两种植入物均能有效增加人类离体眼的 C 值。支架以更大的百分比（73%比 34%）和更大的灌注压力范围（20 至 50mmHg 比 40mmHg）增加 C 值，表明支架对小梁网-Schlemm 管的 8mm 扩张可能在降低流出阻力方面具有额外的益处。Hydrus 微支架可能是一种有效的治疗方法，可增加房水流出系数，从而降低青光眼患者的眼压。
