Glaucoma is a leading cause of irreversible blindness in the world. Glaucoma surgery is commonly considered when glaucoma eye drops and laser therapy fail to adequately lower the intraocular pressure. Glaucoma drainage implants (GDI) were developed to treat patients with secondary glaucoma, pediatric glaucoma and refractory glaucoma after failed trabeculectomy. Unfortunately, the long-term outcome of GDIs has ~ 40% failure rate at 5-year follow-up, largely due to the obstruction of outflow by fibrous encapsulation of the implant. The long-term goal is to improve the outcome for surgical management of glaucoma by prolonging the functional life of a GDI. The overall objective is to address the fibrous encapsulation issues with GDI. The central hypothesis is that it is possible to construct from our novel microfluidic meshwork a GDI that can sustain a fibrosis-free outflow pathway. Guided by strong preliminary data, this hypothesis will be tested by pursuing three specific aims: 1) To establish comprehensive and quantitative understanding of the fluidic and mechanical properties of the microfluidic meshwork; 2) To create a novel GDI based on the microfluidic meshwork (MM-GDI); and 3) To test the tissue reactions and drainage functionality of the MM-GDI in a rabbit eye model. In our preliminary study, we have tested the biocompatibility of the microfluidic meshwork in a rabbit model and observed substantial decrease in fibrotic reactions when compared with conventional GDI. The approach is innovative, in the applicants? opinion, because of the use of microfluidic meshwork, a novel micro-structured material which could directly address the issue of scar formation and prevent the failure of MM-GDI. The proposed research is significant because it is expected to prolong the functional life of a GDI and improve the outcome for surgical management of glaucoma. Moreover, the microfluidic meshwork material can be readily applied to other types of glaucoma implants. The research proposed here will provide important insight into the future developments.
Glaucoma is a leading cause of irreversible blindness in the world. Glaucoma surgery is commonly considered when glaucoma eye drops and laser therapy fail to adequately manage the disease. However, glaucoma surgeries have ~ 40% failure rate at 5-year follow-up. This project will develop a novel glaucoma implant with prolonged functional life and improve the outcome for surgical management of glaucoma.