Qin Qiyu, Zhang Chengshou, Yu Naiji, Jia Fan, Liu Xin, Zhang Qi, Chen Min, Wang Kaijun
Department of Ophthalmology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China.
Adv Ophthalmol Pract Res. 2023 Sep 23;3(4):171-179. doi: 10.1016/j.aopr.2023.09.001. eCollection 2023 Nov-Dec.
Glaucoma is the leading cause of irreversible blindness worldwide. The reduction of intraocular pressure has proved to be the only factor which can be modified in the treatment, and surgical management is one of the important methods for the treatment of glaucoma patients.
In order to increase aqueous humor outflow and further reduce intraocular pressure, various drainage implants have been designed and applied in clinical practice. From initial Molteno, Baerveldt and Ahmed glaucoma implants to the Ahmed ClearPath device, Paul glaucoma implant, EX-PRESS and the eyeWatch implant, to iStent, Hydrus, XEN, PreserFlo, Cypass, SOLX Gold Shunt, etc., glaucoma surgical implants are currently undergoing a massive transformation on their structures and performances. Multitudinous materials have been used to produce these implants, from original silicone and porous polyethylene, to gelatin, stainless steel, SIBS, titanium, nitinol and even 24-carat gold. Moreover, the material geometry, size, rigidity, biocompatibility and mechanism (valved versus nonvalved) among these implants are markedly different. In this review, we discussed the development and material characteristics of both conventional glaucoma drainage devices and more recent implants, such as the eyeWatch and the new minimally invasive glaucoma surgery (MIGS) devices.
Although different in design and materials, these delicate glaucoma surgical implants have widely expanded the glaucoma surgical methods, and improved the success rate and safety of glaucoma surgery significantly. However, all of these glaucoma surgical implants have various limitations and should be used for different glaucoma patients at different conditions.
青光眼是全球不可逆性失明的主要原因。降低眼压已被证明是治疗中唯一可以改变的因素，手术治疗是青光眼患者治疗的重要方法之一。
为了增加房水流出并进一步降低眼压，已设计出各种引流植入物并应用于临床实践。从最初的莫尔顿（Molteno）、贝尔维尔德（Baerveldt）和艾哈迈德（Ahmed）青光眼植入物，到艾哈迈德ClearPath装置、保罗（Paul）青光眼植入物、EX-PRESS和眼监护（eyeWatch）植入物，再到iStent、Hydrus、XEN、PreserFlo、Cypass、SOLX Gold Shunt等，青光眼手术植入物目前在其结构和性能上正在经历巨大变革。已使用多种材料来生产这些植入物，从原始的硅胶和多孔聚乙烯，到明胶、不锈钢、苯乙烯-异丁烯-苯乙烯共聚物（SIBS）、钛、镍钛合金甚至24克拉黄金。此外，这些植入物之间的材料几何形状、尺寸、刚性、生物相容性和机制（带瓣膜与不带瓣膜）明显不同。在本综述中，我们讨论了传统青光眼引流装置以及最新植入物（如眼监护和新型微创青光眼手术（MIGS）装置）的发展和材料特性。
尽管这些精致的青光眼手术植入物在设计和材料上有所不同，但它们广泛扩展了青光眼手术方法，并显著提高了青光眼手术的成功率和安全性。然而，所有这些青光眼手术植入物都有各种局限性，应在不同情况下用于不同的青光眼患者。
