1. Nano-structured glaucoma drainage implant safely and significantly reduces intraocular pressure in rabbits via post-operative outflow modulation
- Author
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Kunal S. Parikh, Aditya Josyula, Ju Young Ahn, Ian Pitha, Revaz Omiadze, Justin Hanes, Youlim Ha, and Laura M. Ensign
- Subjects
Materials for devices ,Biocompatible polymers ,Intraocular pressure ,medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,lcsh:Medicine ,Glaucoma ,Trabeculectomy ,02 engineering and technology ,Article ,03 medical and health sciences ,Engineering ,0302 clinical medicine ,Nanoscience and technology ,Ophthalmology ,medicine ,Animals ,Post operative ,Glaucoma Drainage Implants ,lcsh:Science ,Intraocular Pressure ,Glaucoma drainage implant ,Nanoscale materials ,Multidisciplinary ,business.industry ,lcsh:R ,Health care ,021001 nanoscience & nanotechnology ,medicine.disease ,Materials science ,eye diseases ,Nanostructures ,030221 ophthalmology & optometry ,lcsh:Q ,Outflow ,Rabbits ,sense organs ,0210 nano-technology ,business ,Biomedical engineering ,Shunt (electrical) - Abstract
Glaucoma is a leading cause of irreversible vision loss predicted to affect more than 100 million people by 2040. Intraocular pressure (IOP) reduction prevents development of glaucoma and vision loss from glaucoma. Glaucoma surgeries reduce IOP by facilitating aqueous humor outflow through a vent fashioned from the wall of the eye (trabeculectomy) or a glaucoma drainage implant (GDI), but surgeries lose efficacy overtime, and the five-year failure rates for trabeculectomy and tube shunts are 25–45%. The majority of surgical failures occur due to fibrosis around the vent. Alternatively, surgical procedures can shunt aqueous humor too well, leading to hypotony. Electrospinning is an appealing manufacturing platform for GDIs, as it allows for incorporation of biocompatible polymers into nano- or micro-fibers that can be configured into devices of myriad combinations of dimensions and conformations. Here, small-lumen, nano-structured glaucoma shunts were manufactured with or without a degradable inner core designed to modulate aqueous humor outflow to provide immediate IOP reduction, prevent post-operative hypotony, and potentially offer significant, long-term IOP reduction. Nano-structured shunts were durable, leak-proof, and demonstrated biocompatibility and patency in rabbit eyes. Importantly, both designs prevented hypotony and significantly reduced IOP for 27 days in normotensive rabbits, demonstrating potential for clinical utility.
- Published
- 2020
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