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重新平衡跨板层压力差:一种新型青光眼手术——非人灵长类动物的初步试验

Rebalancing translaminar pressure difference: a novel glaucoma surgery-a pilot trial in non-human primates.

作者信息

Xin Chen, Sang Qing, Wu Shen, Pang Rui-Qi, Lin Dan-Ting, Wang Huai-Zhou, Lu Ning, Wang Ning-Li

机构信息

Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China.

出版信息

Int J Ophthalmol. 2025 Sep 18;18(9):1619-1625. doi: 10.18240/ijo.2025.09.02. eCollection 2025.


DOI:10.18240/ijo.2025.09.02
PMID:40881433
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12378670/
Abstract

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.

摘要

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。

相似文献

[1]
Rebalancing translaminar pressure difference: a novel glaucoma surgery-a pilot trial in non-human primates.

Int J Ophthalmol. 2025-9-18

[2]
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[6]
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[7]
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[8]
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[9]
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本文引用的文献

[1]
Factors Associated With Lamina Cribrosa Microvasculature Determined Through Swept-Source Optical Coherence Tomography Angiography.

J Glaucoma. 2025-4-1

[2]
Age related cerebrospinal fluid flow dynamics in the subarachnoid space of the optic nerve in patients with normal tension glaucoma, measured by diffusion weighted MRI.

Eye (Lond). 2024-9

[3]
Is Glaucoma a Two-Pressure-Related Optic Neuropathy? A Systematic Review and Meta-Analysis.

Turk J Ophthalmol. 2024-4-19

[4]
Progressive Changes in the Neuroretinal Rim and Retinal Nerve Fiber Layer in Glaucoma: Impact of Baseline Values and Floor Effects.

Ophthalmology. 2024-6

[5]
Optic Nerve Subarachnoid Space Posture Dependency - An MRI Study in Subjects With Normal Tension Glaucoma and Healthy Controls.

Invest Ophthalmol Vis Sci. 2023-12-1

[6]
Pharmaceutical Approaches to Normal Tension Glaucoma.

Pharmaceuticals (Basel). 2023-8-17

[7]
Optic Nerve Head Myelin-Related Protein, GFAP, and Iba1 Alterations in Non-Human Primates With Early to Moderate Experimental Glaucoma.

Invest Ophthalmol Vis Sci. 2022-10-3

[8]
3D Microstructure of the Healthy Non-Human Primate Lamina Cribrosa by Optical Coherence Tomography Imaging.

Transl Vis Sci Technol. 2022-4-1

[9]
Special Cerebral and Cerebrospinal Features in Primary Open Angle Glaucoma and Normal Tension Glaucoma.

Klin Monbl Augenheilkd. 2022-2

[10]
Normal-tension glaucoma: Current concepts and approaches-A review.

Clin Exp Ophthalmol. 2022-3

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