Xin Chen, Sang Qing, Wu Shen, Pang Rui-Qi, Lin Dan-Ting, Wang Huai-Zhou, Lu Ning, Wang Ning-Li
Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China.
Int J Ophthalmol. 2025 Sep 18;18(9):1619-1625. doi: 10.18240/ijo.2025.09.02. eCollection 2025.
AIM: To propose a novel glaucoma surgery for rebalancing translaminar pressure difference. METHODS: Three non-human primates with normal eyes and two with laser-induced glaucoma underwent the novel surgical procedure. Cannulation of the subarachnoid space was performed after completion of routine vitrectomy steps. An XEN 45 implant was inserted into the created puncture to communicate between the vitreous body and subarachnoid space. Intraocular pressure (IOP), fundus photography, and spectral-domain optical coherence tomography were assessed at baseline and regular intervals during follow-up. RESULTS: All operated eyes showed IOP reduction in the first postoperative month. Two (2/3) normal eyes and one (1/2) glaucomatous eye maintained lower IOP until 18mo after operation. The XEN 45 implant remained positioned through the lamina cribrosa in all normal eyes but was not detected in two glaucomatous eyes. Complications observed in this study included retinal vascular bleeding in 1/3 normal eyes and XEN implant dislocation in all 2 glaucomatous eyes. CONCLUSION: Subarachnoid space cannulation and mini-shunt implantation may contribute to IOP reduction, possibly by rebalancing translaminar pressure difference and enhancing aqueous humor drainage. The development of a suitable mini-shunt requires further investigation.
目的:提出一种用于重新平衡跨筛板压力差的新型青光眼手术方法。 方法:对3只正常眼的非人灵长类动物和2只激光诱导性青光眼的非人灵长类动物实施了该新型手术。在完成常规玻璃体切割步骤后,进行蛛网膜下腔置管。将XEN 45植入物插入所制造的穿刺孔中,以在玻璃体和蛛网膜下腔之间建立连通。在基线时以及随访期间定期评估眼压(IOP)、眼底照相和光谱域光学相干断层扫描。 结果:所有手术眼在术后第一个月眼压均降低。2只(2/3)正常眼和1只(1/2)青光眼眼在术后18个月内眼压维持较低水平。在所有正常眼中,XEN 45植入物均通过筛板保持在位,但在2只青光眼眼中未检测到。本研究中观察到的并发症包括1/3正常眼中的视网膜血管出血和2只青光眼眼中的XEN植入物脱位。 结论:蛛网膜下腔置管和微型分流器植入可能有助于降低眼压,可能是通过重新平衡跨筛板压力差和增强房水引流来实现的。开发合适的微型分流器需要进一步研究。
Int J Ophthalmol. 2025-9-18
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