Villamarin Adan, Stergiopulos Nikos, Bigler Stéphane, Mermoud André, Moulin Alexandre, Roy Sylvain
Swiss Federal Institute of Technology, Lausanne, Switzerland.
Glaucoma Center Montchoisi Clinic, Lausanne, Switzerland.
Invest Ophthalmol Vis Sci. 2014 Oct 14;55(11):7520-4. doi: 10.1167/iovs.14-14563.
We report on the in vivo testing of a novel noninvasively adjustable glaucoma drainage device (AGDD), which features an adjustable outflow resistance, and assess the safety and efficiency of this implant.
Under general anesthesia, the AGDD was implanted on seven white New Zealand rabbits for a duration of 4 months under a scleral flap in a way analogous to the Ex-PRESS device and set in an operationally closed position. The IOP was measured on a regular basis on the operated and control eyes using a rebound tonometer. Once a month the AGDD was adjusted noninvasively from its fully closed to its fully open position and the resulting pressure drop was measured. The contralateral eye was not operated and served as control. After euthanization, the eyes were collected for histology evaluation.
The mean preoperative IOP was 11.1 ± 2.4 mm Hg. The IOP was significantly lower for the operated eye (6.8 ± 2 mm Hg) compared to the nonoperated eye (13.1 ± 1.6 mm Hg) during the first 8 days after surgery. When opening the AGDD from its fully closed to fully open position, the IOP dropped significantly from 11.2 ± 2.9 to 4.8 ± 0.9 mm Hg (P < 0.05).
Implanting the AGDD is a safe and uncomplicated surgical procedure. The fluidic resistance was noninvasively adjustable during the postoperative period with the AGDD between its fully closed and fully open positions.
我们报告一种新型非侵入性可调式青光眼引流装置(AGDD)的体内测试情况,该装置具有可调的流出阻力,并评估这种植入物的安全性和有效性。
在全身麻醉下,将AGDD以类似于Ex-PRESS装置的方式植入7只白色新西兰兔的巩膜瓣下,持续4个月,并设置在手术关闭位置。使用回弹眼压计定期测量手术眼和对照眼的眼压。每月一次将AGDD从完全关闭位置非侵入性地调整到完全打开位置,并测量由此产生的压力下降。对侧眼不进行手术,作为对照。安乐死后,收集眼睛进行组织学评估。
术前平均眼压为11.1±2.4 mmHg。术后第1个8天,手术眼的眼压(6.8±2 mmHg)明显低于未手术眼(13.1±1.6 mmHg)。当将AGDD从完全关闭位置打开到完全打开位置时,眼压从11.2±2.9 mmHg显著降至4.8±0.9 mmHg(P<0.05)。
植入AGDD是一种安全且简单的手术操作。在术后期间,AGDD在完全关闭和完全打开位置之间时,其流体阻力可通过非侵入方式进行调节。