Depto. de Ingeniería Mecánica, Energética y de los Materiales and Instituto de Computación Científica Avanzada (ICCAEx), Universidad de Extremadura, E-06006, Badajoz, Spain.
Department of Ophthalmology, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.
Biomech Model Mechanobiol. 2021 Dec;20(6):2061-2070. doi: 10.1007/s10237-021-01494-w. Epub 2021 Jul 23.
The main aim of glaucoma treatment is to reduce the intraocular pressure (IOP). One of the most common surgical treatments of glaucoma is the implantation of a glaucoma drainage device to drain the aqueous humor from the anterior chamber to a filtration bleb, where the aqueous humor is absorbed. In some cases, the excess of drainage causes ocular hypotony, which constitutes a sight-threatening complication. To prevent hypotony after this intervention, surgeons frequently introduce a suture into the device tube, which increases the hydraulic resistance of the tube and, therefore, the IOP. This study aims to provide an analytical model to correct hypotony following implantation surgery of a glaucoma drainage device, which may help glaucoma surgeons decide on hypotony treatment. The results indicate that the IOP after implanting a cylindrical tube around 300 μm in diameter is essentially the same as that built up in the filtering bleb and can hardly be controlled by introducing a straight suture unless the suture diameter is slightly lower than that of the tube. On the contrary, when the tube diameter is smaller than, for example, 100 μm, significant reductions of the IOP can be obtained by introducing a thin suture into the tube.
青光眼治疗的主要目的是降低眼内压（IOP）。青光眼最常见的手术治疗之一是植入青光眼引流装置，将房水从前房引流到滤过泡，房水在那里被吸收。在某些情况下，过多的引流会导致眼球压低，这构成了一种威胁视力的并发症。为了防止这种干预后的眼压过低，外科医生经常在装置管中引入缝线，这会增加管的液压阻力，从而增加眼压。本研究旨在提供一种分析模型来纠正青光眼引流装置植入手术后的眼压过低，这可能有助于青光眼外科医生决定眼压过低的治疗方法。结果表明，植入直径约 300μm 的圆柱形管后的眼压基本上与滤过泡中的眼压相同，除非缝线直径略小于管直径，否则很难通过引入直缝线来控制。相反，当管直径小于例如 100μm 时，通过向管中引入细缝线可以显著降低眼压。
